Provider Demographics
NPI:1043359128
Name:BEAN-BATES, RHEA (DPT)
Entity type:Individual
Prefix:DR
First Name:RHEA
Middle Name:
Last Name:BEAN-BATES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 TOWNSEND RD
Mailing Address - Street 2:#415
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-4569
Mailing Address - Country:US
Mailing Address - Phone:904-778-4382
Mailing Address - Fax:
Practice Address - Street 1:6248 103RD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-7733
Practice Address - Country:US
Practice Address - Phone:904-573-0046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist