Provider Demographics
NPI:1174780043
Name:BARJE, SUZANNE (PT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BARJE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10337 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6287
Mailing Address - Country:US
Mailing Address - Phone:904-292-1808
Mailing Address - Fax:904-288-8758
Practice Address - Street 1:10337 SAN JOSE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6287
Practice Address - Country:US
Practice Address - Phone:904-292-1808
Practice Address - Fax:904-288-8758
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist