Provider Demographics
NPI:1881161495
Name:GOLDHEART PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:GOLDHEART PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:AKBARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-424-7809
Mailing Address - Street 1:3678 JACOB LOIS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-2968
Mailing Address - Country:US
Mailing Address - Phone:904-424-7809
Mailing Address - Fax:
Practice Address - Street 1:2624 ATLANTIC BLVD STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3633
Practice Address - Country:US
Practice Address - Phone:904-424-7809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty