Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John Kwak-Hefferan

Individual provider Physical Therapy Assistant · NPI 1316391014

John Kwak-Hefferan is a Physical Therapy Assistant in Port Orange, Florida. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8311
Phone: (800) 330-7711
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160007217 (IL)

Record details

NPI number1316391014
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 19, 2016
Last updated in NPPESApril 19, 2016
Mailing address5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311

Other providers in Port Orange