Active NPI
Laura Bunso, PT
- Physical Therapist
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 018144
- Practice address
- 12421 San Jose Blvd # 100a
Jacksonville, FL 32223-2680 - Phone
- (904) 296-4140
- Fax
- (904) 279-0963
- NPI assigned
- Aug 1, 2007
- Last updated
- Apr 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 018144 | FL | Primary |
Addresses
Primary practice location
12421 San Jose Blvd # 100a
Jacksonville, FL 32223-2680
Mailing address
10950 60 San Jose Blvd 196
Jacksonville, FL 32223-2336
Phone (904) 296-4140
Other practice location 1
165 Hampton Point Dr Ste 3A
St Augustine, FL 32092-3062
Phone (904) 296-4140
Other practice location 2
30 Tavernier Dr Ste A
Ponte Vedra, FL 32081-1270
Phone (904) 296-4140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12421 San Jose Blvd
Suite 100
Jacksonville, FL 32223-8662
Phone (904) 296-4140
30 Tavernier Dr
Suite a
Ponte Vedra, FL 32081-1270
Phone (904) 296-4140
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018144 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smart Body Physical Therapy Inc | Current | Accepting new patients |
Locations
10950 San Jose Blvd
#196
Jacksonville, FL 32223
11555 Central Pkwy
Ste 202
Jacksonville, FL 32224
Phone (904) 296-4140
6885 Belfort Oaks Pl
Ste 310
Jacksonville, FL 32216
Phone (904) 296-4140
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Jacksonville, FL
- NPI 1396767018
-
- Physical Therapy Clinic/Center
- Jacksonville, FL
- NPI 1255508008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775088000000",
"number": "1053502393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10950 60 SAN JOSE BLVD 196",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322232336",
"telephone_number": "904-296-4140",
"fax_number": "904-279-0963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12421 SAN JOSE BLVD # 100A",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322232680",
"telephone_number": "904-296-4140",
"fax_number": "904-279-0963"
}
],
"practiceLocations": [
{
"address_1": "165 Hampton Point Dr Ste 3A",
"address_purpose": "LOCATION",
"city": "St Augustine",
"state": "FL",
"postal_code": "320923062",
"country_code": "US",
"telephone_number": "904-296-4140",
"fax_number": "904-279-0963",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "30 Tavernier Dr Ste A",
"address_purpose": "LOCATION",
"city": "Ponte Vedra",
"state": "FL",
"postal_code": "320811270",
"country_code": "US",
"telephone_number": "904-296-4140",
"fax_number": "904-279-0963",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUNSO",
"first_name": "LAURA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-01",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "018144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.