Basic Information
| Provider Information | |||||||||
| NPI: | 1922271683 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACCELERATED HEALTH SYSTEMS OF FLORIDA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 635366 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452635366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008206521 | ||||||||
| FaxNumber: | 5137420943 | ||||||||
| Practice Location | |||||||||
| Address1: | 4175 S CONGRESS AVE | ||||||||
| Address2: | SUITE W | ||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334614725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612966202 | ||||||||
| FaxNumber: | 5612966204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2008 | ||||||||
| LastUpdateDate: | 04/02/2008 | ||||||||
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| AuthorizedOfficialLastName: | OSWALD | ||||||||
| AuthorizedOfficialFirstName: | ELAINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 5616242706 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | R.N. | ||||||||
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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.