Provider Demographics
NPI:1215163191
Name:SCHMITT, JOSHUA G (DPT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:G
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 CEDAR RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6534
Mailing Address - Country:US
Mailing Address - Phone:318-366-4647
Mailing Address - Fax:
Practice Address - Street 1:100 EXECUTIVE WAY
Practice Address - Street 2:SUITE 109
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2715
Practice Address - Country:US
Practice Address - Phone:904-543-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT24702OtherFL PT LICENSE