Provider Demographics
NPI:1366682965
Name:HIAWASSEE HEALTH & REHAB CENTER
Entity Type:Organization
Organization Name:HIAWASSEE HEALTH & REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODRIGUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSSOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-403-5400
Mailing Address - Street 1:6500 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-7800
Mailing Address - Country:US
Mailing Address - Phone:407-403-5400
Mailing Address - Fax:407-403-5401
Practice Address - Street 1:6500 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-7800
Practice Address - Country:US
Practice Address - Phone:407-403-5400
Practice Address - Fax:407-403-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
FL305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty