Provider Demographics
NPI:1114412962
Name:SEMINOLE CARE & REHAB CENTER, INC.
Entity Type:Organization
Organization Name:SEMINOLE CARE & REHAB CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BULES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-514-7449
Mailing Address - Street 1:10875 PARK BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-5456
Mailing Address - Country:US
Mailing Address - Phone:727-256-2296
Mailing Address - Fax:
Practice Address - Street 1:10875 PARK BLVD STE B1
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-5456
Practice Address - Country:US
Practice Address - Phone:727-256-2296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC1132C111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty