Individual ProviderStanley OctaviusPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6210 Beach Blvd, Jacksonville, FL 32216-2706(904) 345-8100(904) 345-7215PECOS EnrollmentBased on the most recent information from CMS, provider Stanley Octavius 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 ID1679212419Provider TypeIndividualFull NameOctavius, StanleyCredentialDPTGenderMaleSole ProprietorNoEnumeration Date5/31/2022Last Updated5/31/2022Contact InformationPractice LocationPractice Address6210 Beach Blvd, Jacksonville, FL 32216-2706Phone(904) 345-8100FaxUnlisted FaxMailing LocationMailing Address3901 University Blvd S, Jacksonville, FL 32216-4312Phone(904) 345-7215FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer