Razel B. Icban, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6377 Issued in FL

Practice address

3937 Spring Park Rd
Jacksonville, FL 32207-5739

Phone

(904) 737-6777

NPI assigned

Jan 6, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1003894387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9318 OSTERLEY CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322447134",
            "telephone_number": "904-207-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 SPRING PARK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075739",
            "telephone_number": "904-737-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICBAN",
        "first_name": "RAZEL",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT6377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ic Med Supply Inc
• Ic Medical Services, P.a.
• Icare Provider Services
• Icats Lakeland LLC
• Veronica Icaza Galindo, MD
• Cassie G. Ice, R.PH.
• Juana R Icon
• Iconnect Jax
• Id Associates of Jacksonville PA
• Idea Florida, Inc.

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.