Provider Demographics
NPI:1063726123
Name:VAKIL THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:VAKIL THERAPEUTIC SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:FROMME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-619-1587
Mailing Address - Street 1:12795 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-2669
Mailing Address - Country:US
Mailing Address - Phone:904-619-1587
Mailing Address - Fax:
Practice Address - Street 1:12795 SAN JOSE BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-2669
Practice Address - Country:US
Practice Address - Phone:904-619-1587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-31
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty