Provider Demographics
NPI:1750317160
Name:JOSEPH E GILLESPIE INC
Entity Type:Organization
Organization Name:JOSEPH E GILLESPIE INC
Other - Org Name:GILLESPIE & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-965-1079
Mailing Address - Street 1:5030 CHAMPION BLVD
Mailing Address - Street 2:SUITE G11-279
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2473
Mailing Address - Country:US
Mailing Address - Phone:561-715-8958
Mailing Address - Fax:
Practice Address - Street 1:5400 CHAMPION BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-1607
Practice Address - Country:US
Practice Address - Phone:561-912-1014
Practice Address - Fax:561-955-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0308AMedicare ID - Type UnspecifiedPHYSICAL THERAPIST
FLK7438Medicare ID - Type UnspecifiedPHYSICAL THERAPIST