Provider Demographics
NPI:1033878152
Name:ALPHA MEDICINE AND REHAB, LLC
Entity Type:Organization
Organization Name:ALPHA MEDICINE AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-319-3933
Mailing Address - Street 1:PO BOX 420037
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34742-0037
Mailing Address - Country:US
Mailing Address - Phone:239-319-3933
Mailing Address - Fax:239-350-5380
Practice Address - Street 1:2503 DEL PRADO BLVD S STE 510
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5709
Practice Address - Country:US
Practice Address - Phone:239-319-3933
Practice Address - Fax:239-350-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty