Provider Demographics
NPI:1902136575
Name:FLORIDA REHAB CENTER
Entity Type:Organization
Organization Name:FLORIDA REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:AMABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LATORRE-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-237-4450
Mailing Address - Street 1:6506 N FLORIDA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6060
Mailing Address - Country:US
Mailing Address - Phone:813-237-4450
Mailing Address - Fax:813-237-4400
Practice Address - Street 1:6506 N FLORIDA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-6060
Practice Address - Country:US
Practice Address - Phone:813-237-4450
Practice Address - Fax:813-237-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM24186261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service