Basic Information
Provider Information
NPI: 1134216658
EntityType: 2
ReplacementNPI:  
OrganizationName: FLORIDA REHABILITATION SERVICES LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ACCELERATED REHABILITATION CENTERS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2252 WAYCROSS ROAD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 45240
CountryCode: US
TelephoneNumber: 5137422333
FaxNumber: 5137420943
Practice Location
Address1: 6451 N FEDERAL HIGHWAY
Address2: #127
City: FORT LAUDERDALE
State: FL
PostalCode: 33308
CountryCode: US
TelephoneNumber: 9546896797
FaxNumber: 9546896264
Other Information
ProviderEnumerationDate: 10/06/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: OSWALD
AuthorizedOfficialFirstName: ELAINE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CREDENTIALING
AuthorizedOfficialTelephone: 5616242706
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: RN
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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