Provider Demographics
NPI:1427936822
Name:GILLES, JODI (DPT)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:GILLES
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 1:14320 DOVEWIND CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5537
Mailing Address - Country:US
Mailing Address - Phone:321-438-0834
Mailing Address - Fax:
Practice Address - Street 1:1100 CIRCLE 75 PKWY SE STE 1400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3067
Practice Address - Country:US
Practice Address - Phone:678-403-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015426A225100000X
FL32832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist