Provider Demographics
NPI:1710021282
Name:LOVE, JAMES MILES (PT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MILES
Last Name:LOVE
Suffix:
Gender:M
Credentials:PT, ATC
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Mailing Address - Street 1:5755 99TH AVENUE CIR E
Mailing Address - Street 2:HARRISON RANCH
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-4441
Mailing Address - Country:US
Mailing Address - Phone:941-721-6922
Mailing Address - Fax:941-721-6922
Practice Address - Street 1:5755 99TH AVENUE CIR E
Practice Address - Street 2:HARRISON RANCH
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-4441
Practice Address - Country:US
Practice Address - Phone:941-721-6922
Practice Address - Fax:941-721-6922
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPT183962251X0800X
AZPT51802251X0800X
FLAL1672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892166100Medicaid
FL892166100Medicaid