Stevens, Gerald Allen

Stevens, Gerald Allen is an individual health care provider with primary practice located at 11945 San Jose Blvd Suite 202, Jacksonville FL 32223-1613. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Stevens, Gerald Allen can be contacted via phone (904) 880-2424.

Contact Information

Primary practice address
11945 San Jose Blvd Suite 202 Jacksonville FL 32223-1613
Phone: (904) 880-2424
Fax: (904) 880-2420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AL 428 Florida

Profile Details

NPI number 1720069065
LBN Legal business name Stevens, Gerald Allen
Credentials ATC, LAT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2005
Last updated Jul 8th, 2007 - about 19 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 1720069065 NPPES
Florida Other AL 428 STATE LICENSE

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