Provider Demographics
NPI:1184060899
Name:SIBILLE, WILLIAM JOSEPH (DPT)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:SIBILLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:360 PALM COAST PKWY NE
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3805
Mailing Address - Country:US
Mailing Address - Phone:904-501-4344
Mailing Address - Fax:386-447-2161
Practice Address - Street 1:360 PALM COAST PKWY NE
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3805
Practice Address - Country:US
Practice Address - Phone:386-446-4101
Practice Address - Fax:386-447-2161
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 21524225100000X
FLPT21524208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT21524OtherFLORIDA BOARD OF PHYSICAL THERAPY