Jacksonville Injury & Rehab

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JACKSONVILLE INJURY & REHAB

Practice address

859 Park Ave.,
Suite # 102
Orange Park, FL 32073

Phone

(904) 278-7411

Fax

(904) 278-4446

NPI assigned

Mar 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Reynaldo Perez, D.C.

Title

Managing Member

Phone

(904) 278-7411

Specialties & licenses 3

Addresses

Tax ID family

Jacksonville Injury Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jacksonville Injury & Rehab

  • Chiropractor
  • Orange Park, FL
  • NPI 1154624625
  NPD tax ID

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1235479130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 PARK AVE STE 102",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734151",
            "telephone_number": "904-278-7411",
            "fax_number": "904-278-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 PARK AVE.,",
            "address_2": "SUITE # 102",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-278-7411",
            "fax_number": "904-278-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE INJURY & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "904-278-7411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Jackson, LCSW
• Domonique Jackson, LCSW
• Jacksonville Community Midwives LLC
• Jacksonville Emergency Consultants,PA
• Jacksonville Injury & Rehab
• Jacksonville Medical Group, LLC
• Jacksonville Ms and Neurology Center, P.a.
• Jacksonville Multispecialty Services, LLC
• Jacksonville Neurological Clinic, P.a.
• Jacksonville Outpatient Surgery Center, LLC

• Chiropractor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.