Basic Information
Provider Information
NPI: 1932419355
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QUAINTANCE
FirstName: SHEILA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.P.T.
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 2700 RIVERSIDE AVE
Address2: SUITE 4
City: JACKSONVILLE
State: FL
PostalCode: 322058275
CountryCode: US
TelephoneNumber: 9042826331
FaxNumber:  
Practice Location
Address1: 1819 HENDRICKS AVE
Address2: SUITES 2 & 3
City: JACKSONVILLE
State: FL
PostalCode: 322073303
CountryCode: US
TelephoneNumber: 9043485511
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/19/2010
LastUpdateDate: 04/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT25568FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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