Provider Demographics
NPI:1043216476
Name:OCALA REHABILITATION ASSOCIATES PA
Entity Type:Organization
Organization Name:OCALA REHABILITATION ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, PHYSICAL THERAPIS
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HARTSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:352-351-4141
Mailing Address - Street 1:1536 E SILVER SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6804
Mailing Address - Country:US
Mailing Address - Phone:352-351-4141
Mailing Address - Fax:352-351-1889
Practice Address - Street 1:1536 E SILVER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6804
Practice Address - Country:US
Practice Address - Phone:352-351-4141
Practice Address - Fax:352-351-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6487225100000X
FLPTA16613225200000X
FLOT11312225XH1200X
FLSA2999235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL843074OtherMPN - OT
FL818716OtherMPN - PT
FLR4MOtherBCBS
FLR4MOtherBCBS
FL843074OtherMPN - OT