Provider Demographics
NPI:1114026200
Name:H2 REHABILITATION SERVICES OF FLORIDA LLC
Entity Type:Organization
Organization Name:H2 REHABILITATION SERVICES OF FLORIDA LLC
Other - Org Name:H2 HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STREETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-699-9395
Mailing Address - Street 1:PO BOX 932184
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-4912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 WALLACE RD
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-8069
Practice Address - Country:US
Practice Address - Phone:386-427-4866
Practice Address - Fax:386-427-4456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0920866OtherCIGNA
FL102701OtherAVMED
FL4477946OtherAETNA NON-HMO
FL160630508OtherDEPARTMENT OF LABOR
FL8845212-29Medicaid
FL028583800Medicaid
FLRF2OtherBCBS
FL028583800Medicaid
FL102701OtherAVMED
FL160630508OtherDEPARTMENT OF LABOR