1285951764 NPI number — REHAB AFTER WORK OF FLORIDA, LLC

Table of content: (NPI 1285951764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285951764 NPI number — REHAB AFTER WORK OF FLORIDA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REHAB AFTER WORK OF FLORIDA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285951764
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5405 OKEECHOBEE BLVD
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33417-4543
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-587-7771
Provider Business Mailing Address Fax Number:
954-208-5770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
773 W LUMSDEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRANDON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33511-6261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-587-7771
Provider Business Practice Location Address Fax Number:
954-208-5770
Provider Enumeration Date:
04/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MURRAY
Authorized Official First Name:
GUY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
954-587-7771

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  1329AD743501 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com