| |
1405 S Orange Ave Ste 101, Orlando, FL 32806-2147 | |
(407) 522-4525 | |
(407) 299-2344 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Rehabilitation |
Location | 1405 S Orange Ave Ste 101, Orlando, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194859165 | NPI | - | NPPES |
104692700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 150, Lima, OH 45802-0150 Ph: (419) 221-6717 | 1405 S Orange Ave Ste 101, Orlando, FL 32806-2147 Ph: (407) 522-4525 |