Provider Demographics
NPI:1538417373
Name:CORA RAHABILITATION
Entity type:Organization
Organization Name:CORA RAHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PTA
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORCOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-734-9400
Mailing Address - Street 1:1590 SR 15A
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720
Mailing Address - Country:US
Mailing Address - Phone:386-734-9400
Mailing Address - Fax:386-734-8866
Practice Address - Street 1:1590 SR 15A
Practice Address - Street 2:SUITE 2
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720
Practice Address - Country:US
Practice Address - Phone:386-734-9400
Practice Address - Fax:386-734-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23522261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy