Basic Information
| Provider Information | |||||||||
| NPI: | 1538331590 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABILUTY REHABILITATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1337 S INTERNATIONAL PKWY STE 1321 | ||||||||
| Address2: | |||||||||
| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327461402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078330802 | ||||||||
| FaxNumber: | 4078338931 | ||||||||
| Practice Location | |||||||||
| Address1: | 1337 S INTERNATIONAL PKWY STE 1321 | ||||||||
| Address2: | |||||||||
| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327461402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078330802 | ||||||||
| FaxNumber: | 4078338931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2008 | ||||||||
| LastUpdateDate: | 03/31/2008 | ||||||||
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| AuthorizedOfficialLastName: | OATES | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 3212173377 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | PTA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | PTA 21177 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.