| Powerback Rehabilitation Llc | |
|
1501 Sunshine Pkwy Tavares FL 32778-4496 | |
| (352) 508-7620 | |
| Not Available |
| Full Name | Powerback Rehabilitation Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1501 Sunshine Pkwy, Tavares, Florida |
| Authorized Official Name and Position | Carl Anthony Shrom (CEO) |
| Authorized Official Contact | 2158960422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Powerback Rehabilitation Llc 101 E State St C/o Amy Nunemaker Kennett Square PA 19348-3109 Ph: (610) 925-4560 | Powerback Rehabilitation Llc 1501 Sunshine Pkwy Tavares FL 32778-4496 Ph: (352) 508-7620 |
| NPI Number | 1477964823 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 02/11/2025 |
| Medicare PECOS PAC ID | 2365359932 |
|---|---|
| Medicare Enrollment ID | O20140619002211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477964823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Primary |
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