Provider Demographics
NPI:1306843164
Name:R&R PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:R&R PHYSICAL THERAPY INC.
Other - Org Name:R&R PHYSICAL THERAPY CONSULTANT AND REHABILITATION SERVICES INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MANZO
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:850-656-3163
Mailing Address - Street 1:1818 MICCOSUKEE COMMONS DR.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-656-3163
Mailing Address - Fax:850-656-3463
Practice Address - Street 1:1818 MICCOSUKEE COMMONS DR.
Practice Address - Street 2:SUITE 3
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-656-3163
Practice Address - Fax:850-656-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY907HOtherBCBS OF FL
=========OtherUNIVERSAL HEALTHCARE
FLY907HOtherBCBS OF FL
K4703Medicare ID - Type Unspecified