Provider Demographics
NPI:1346509122
Name:DG REHAB AND ENTERTAINMENT, INC.
Entity Type:Organization
Organization Name:DG REHAB AND ENTERTAINMENT, INC.
Other - Org Name:ORTHOSPINE AND SPORT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIGIOVANNA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:727-254-6455
Mailing Address - Street 1:3230 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3012 STARKEY BLVD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-2175
Practice Address - Country:US
Practice Address - Phone:727-254-6455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty