Provider Demographics
NPI:1467188060
Name:GLOBENSKY, LIAM
Entity Type:Individual
Prefix:
First Name:LIAM
Middle Name:
Last Name:GLOBENSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 FIRST COAST HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-5598
Mailing Address - Country:US
Mailing Address - Phone:904-321-5491
Mailing Address - Fax:
Practice Address - Street 1:4800 FIRST COAST HWY STE 240
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-5598
Practice Address - Country:US
Practice Address - Phone:904-321-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist