Provider Demographics
NPI:1285207936
Name:CENTER OF RECOVERY & EXERCISE (CORE)
Entity Type:Organization
Organization Name:CENTER OF RECOVERY & EXERCISE (CORE)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-951-8936
Mailing Address - Street 1:1191 COMMERCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2035
Mailing Address - Country:US
Mailing Address - Phone:407-951-8936
Mailing Address - Fax:407-636-5235
Practice Address - Street 1:1191 COMMERCE PARK DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2035
Practice Address - Country:US
Practice Address - Phone:407-951-8936
Practice Address - Fax:407-636-5235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1740529650OtherREHABILITATION PRACTITIONER