Provider Demographics
NPI:1922414556
Name:PIRANI, DIVYA MAJMUDAR (PT, DPT, PCS)
Entity Type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:MAJMUDAR
Last Name:PIRANI
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6817 SOUTHPOINT PKWY STE 1602
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6298
Mailing Address - Country:US
Mailing Address - Phone:904-945-7556
Mailing Address - Fax:904-379-0113
Practice Address - Street 1:6817 SOUTHPOINT PKWY STE 1602
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6298
Practice Address - Country:US
Practice Address - Phone:919-247-2450
Practice Address - Fax:904-379-0113
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012894300Medicaid