| Vjwdc, Inc | |
|
10550 Deerwood Park Blvd Ste 609b Jacksonville FL 32256-2811 | |
| (904) 513-3954 | |
| Not Available |
| Full Name | Vjwdc, Inc |
|---|---|
| Speciality | Physical Therapist |
| Location | 10550 Deerwood Park Blvd Ste 609b, Jacksonville, Florida |
| Authorized Official Name and Position | Vanessa Wilczak (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9045133954 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vjwdc, Inc Po Box 935934 Atlanta GA 31193-5934 Ph: (941) 209-5410 | Vjwdc, Inc 10550 Deerwood Park Blvd Ste 609b Jacksonville FL 32256-2811 Ph: (904) 513-3954 |
| NPI Number | 1578223764 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 04/25/2025 |
| Medicare PECOS PAC ID | 0547588659 |
|---|---|
| Medicare Enrollment ID | O20220203000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578223764 | NPI | - | NPPES |
| Provider Name | Gregory Mcnamara |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720051832 PECOS PAC ID: 5496796799 Enrollment ID: I20080725000654 |
| Provider Name | Vanessa J Wilczak |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366775124 PECOS PAC ID: 1658414412 Enrollment ID: I20100203000041 |
| Provider Name | Craig A Cherrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194267625 PECOS PAC ID: 1557645405 Enrollment ID: I20170221002459 |
| Provider Name | Harsh Dangaria |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861789992 PECOS PAC ID: 3870712672 Enrollment ID: I20170620001739 |
| Provider Name | Shannon J O Brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245614114 PECOS PAC ID: 6305147976 Enrollment ID: I20191111000363 |
| Provider Name | Chelsea L Toldi |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851787790 PECOS PAC ID: 6204131162 Enrollment ID: I20210105001932 |
| Provider Name | Adam Whalen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1396067963 PECOS PAC ID: 5092033100 Enrollment ID: I20220119001273 |
| Provider Name | Renu Gautam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558744417 PECOS PAC ID: 4284920752 Enrollment ID: I20220629001205 |
| Provider Name | Luis Damaso Garcia |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225744287 PECOS PAC ID: 6002276920 Enrollment ID: I20230724001557 |
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