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Contact Information

MARK N CICCARELLO, PT, DPT
5539 ROOSEVELT BLVD
JACKSONVILLE, FL32244-2345
 Phone: 904-483-2272
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MARK N CICCARELLO · (Male)

NPI Number 1962287359
Status Active
Credentials PT, DPT
Entity Individual
Enumeration date 08/25/2023
Last updated 08/25/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • FL License # 40666
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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