Provider Demographics
NPI:1376662593
Name:BAY AREA INJURY REHAB SPECIALISTS HOLDINGS INC
Entity Type:Organization
Organization Name:BAY AREA INJURY REHAB SPECIALISTS HOLDINGS INC
Other - Org Name:BAY AREA INJURY REHAB SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER CORPORATE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-936-0419
Mailing Address - Street 1:PO BOX 15265
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-5265
Mailing Address - Country:US
Mailing Address - Phone:813-930-8454
Mailing Address - Fax:813-936-2690
Practice Address - Street 1:7171 N DALE MABRY HWY
Practice Address - Street 2:SUITE 503
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2630
Practice Address - Country:US
Practice Address - Phone:813-930-8454
Practice Address - Fax:813-930-9554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty