Individual ProviderJacqueline A OsbornePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3599 University Blvd S, Jacksonville, FL 32216-4252(904) 345-7607PECOS EnrollmentBased on the most recent information from CMS, provider Jacqueline A Osborne does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1306869037Provider TypeIndividualFull NameOsborne, Jacqueline ATitleDr.CredentialDPTGenderFemaleSole ProprietorNoEnumeration Date7/25/2006Last Updated4/23/2013Contact InformationPractice LocationPractice Address3599 University Blvd S, Jacksonville, FL 32216-4252Phone(904) 345-7607FaxUnlisted FaxMailing LocationMailing Address3599 University Blvd S, Jacksonville, FL 32216-4252Phone(904) 345-7607FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT21023FloridaProvider IdentifiersIDDescriptionIssuerID888889200DescriptionMedicaidIssuerUnlistedFloridaIDY036EDescriptionOtherIssuerBLUE CROSS BLUE SHIELDFlorida