OrganizationActive
Providian Functional Capacity Specialists
NPI 1013258862 · Physical Therapy Clinic/Center · Green Cove Springs, FL
Provider details
- NPI number
- 1013258862
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Brian Imler, President(904) 982-5762
- License
- AL1714 (FL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
716 N Orange Ave
Green Cove Springs, FL 32043-2920
Phone: (888) 957-3337
Fax: (904) 284-4244
Street-level locationGet directions
Mailing address
716 N Orange Ave
Green Cove Springs, FL 32043-2920
Other names (DBA / former)
- Doing business as
- Providian Physical Therapy and Functional Capacity Specialists
Registry dates
- Enumerated
- 2013-03-04
- Last updated
- 2013-03-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.