Hodge, Jonathan David

Hodge, Jonathan David is an individual health care provider with primary practice located at 1075 Mason Ave , Daytona Beach FL 32117-4611. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Hodge, Jonathan David can be contacted via phone (386) 255-4596.

Contact Information

Primary practice address
1075 Mason Ave Daytona Beach FL 32117-4611
Phone: (386) 255-4596
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT36234 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT36234 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 36234 Florida

Profile Details

NPI number 1659988996
LBN Legal business name Hodge, Jonathan David
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2020
Last updated Feb 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659988996 NPPES
Florida MEDICAID 108341400

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