Provider Demographics
NPI:1790764116
Name:FOCUS PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:FOCUS PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CRAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:904-388-1300
Mailing Address - Street 1:869 STOCKTON ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3557
Mailing Address - Country:US
Mailing Address - Phone:904-388-1300
Mailing Address - Fax:904-388-1302
Practice Address - Street 1:869 STOCKTON ST
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-3557
Practice Address - Country:US
Practice Address - Phone:904-388-1300
Practice Address - Fax:904-388-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY915QOtherBLUE CROSS BLUE SHIELD
FLK8401Medicare ID - Type UnspecifiedGROUP