Staci Gullman, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA21464 Issued in FL

Practice address

8087 Normandy Blvd
Jacksonville, FL 32221-6646

Phone

(904) 781-5666

Fax

(904) 781-8191

NPI assigned

Dec 17, 2008

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": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1659517951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 NOTTINGHAM DR E",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322597904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8087 NORMANDY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322216646",
            "telephone_number": "904-781-5666",
            "fax_number": "904-781-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLMAN",
        "first_name": "STACI",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA21464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danicklyn Gullage
• Brandon Cierra Gullatt
• Lacy Danielle Gulledge, ARNP
• Jasmine Gullett, BCBA
• Edwin Howard Gullison Jr., CRNA
• Monique Gullo, MSW
• Jeffrey R Gully, DMD
• Musab Gulzar
• Tariq Gulzar, M.D.
• Bharat Kumar Gummadi, MD

• Physical Therapy Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.