Provider Demographics
NPI:1750535316
Name:JOB, JEFFREY J
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:J
Last Name:JOB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7666
Mailing Address - Country:US
Mailing Address - Phone:407-957-4707
Mailing Address - Fax:
Practice Address - Street 1:601 E OAK ST STE A
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4574
Practice Address - Country:US
Practice Address - Phone:407-847-5282
Practice Address - Fax:407-847-9943
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19794225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist