Basic Information
| Provider Information | |||||||||
| NPI: | 1962633016 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABILITY REHABILITATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 W DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | DELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327205812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3868827406 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1565 SAXON BLVD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | DELTONA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327255876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3868510901 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 08/06/2009 | ||||||||
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| AuthorizedOfficialLastName: | GUERRINA | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3865471690 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | 21778 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.