Individual ProviderChristina Marie LongobuccoPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4203 Belfort Rd, Jacksonville, FL 32216-1409(904) 296-3711PECOS EnrollmentBased on the most recent information from CMS, provider Christina Marie Longobucco 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 ID1750364667Provider TypeIndividualFull NameLongobucco, Christina MarieTitleMs.CredentialPTGenderFemaleSole ProprietorNoEnumeration Date11/23/2005Last Updated4/9/2010Contact InformationPractice LocationPractice Address4203 Belfort Rd, Jacksonville, FL 32216-1409Phone(904) 296-3711Fax(904) 296-4088Mailing LocationMailing Address4203 Belfort Rd, Suite 115, Jacksonville, FL 32216-1409Phone(904) 296-3711Fax(904) 296-4088Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT18224FloridaProvider IdentifiersIDDescriptionIssuerIDY035UDescriptionOtherIssuerBLUECROSS/BLUESHIELDFloridaIDP00049736DescriptionOtherIssuerRAILROAD MEDICAREFlorida