| Active For Life Rehabilitation, Llc | |
|
4164 Lonicera Loop, Saint Johns, FL 32259-4531 | |
| (904) 891-1179 | |
| (904) 212-1202 |
| Full Name | Active For Life Rehabilitation, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 4164 Lonicera Loop, Saint Johns, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639410384 | NPI | - | NPPES |
| 010501000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT 21700 (Florida) | Primary |
| Provider Name | Geoffrey G Angell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457691065 PECOS PAC ID: 1759528706 Enrollment ID: I20130626000641 |
| Mailing Address | Practice Location Address |
|---|---|
| Active For Life Rehabilitation, Llc 4164 Lonicera Loop, Saint Johns, FL 32259-4531 Ph: (904) 891-1179 | Active For Life Rehabilitation, Llc 4164 Lonicera Loop, Saint Johns, FL 32259-4531 Ph: (904) 891-1179 |
Mrs. Amanda (amy) Gibbes, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 924 Lotus Ln S, Saint Johns, FL 32259 Phone: 904-429-2001 | |
Tobi Fox Baldwin, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2758 Race Track Rd, Suite 401, Saint Johns, FL 32259 Phone: 904-894-8789 | |
Mrs. Roseann Jackson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 197 Elmwood Dr, Saint Johns, FL 32259 Phone: 904-230-8139 | |
Mr. Fernando Santos Sta-maria, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1097 Flora Parke Dr, Saint Johns, FL 32259 Phone: 904-287-7540 | |
Leslie Jones De Jong, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 183 Sweetbrier Branch Ln, Saint Johns, FL 32259 Phone: 904-287-1820 | |
Kinetic Image Corp Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1307 Whispering Pines Rd, Saint Johns, FL 32259 Phone: 904-635-4638 | |
Vibeth Jude Vicher-vesagas, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 813 S Bridgestone Ave, Saint Johns, FL 32259 Phone: 904-535-7775 |