Basic Information
| Provider Information | |||||||||
| NPI: | 1598824435 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLORIDA REHABILITATION SERVICES | ||||||||
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| OtherOrganizationName: | ACCELERATED REHABILITATION CENTERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2252 WAYCROSS ROAD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137422333 | ||||||||
| FaxNumber: | 5137420943 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 S MAIN STREET | ||||||||
| Address2: | SUITE 13 | ||||||||
| City: | BELLE GLADE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619968086 | ||||||||
| FaxNumber: | 5619962905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BOLERA | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | JAY | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5318275824 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.