Provider Demographics
NPI:1922314152
Name:JANI, NEHA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:NEHA
Middle Name:
Last Name:JANI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SOUTHPARK BLVD STE B201
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5159
Mailing Address - Country:US
Mailing Address - Phone:904-824-1636
Mailing Address - Fax:904-824-7488
Practice Address - Street 1:105 SOUTHPARK BLVD STE B201
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5159
Practice Address - Country:US
Practice Address - Phone:904-824-1636
Practice Address - Fax:904-824-7488
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist