Provider Demographics
NPI:1386839256
Name:WELLNESS REHAB USA, INC
Entity Type:Organization
Organization Name:WELLNESS REHAB USA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSMIRA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT-CWS-CFO
Authorized Official - Phone:561-703-5115
Mailing Address - Street 1:1519 FENTON DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3555
Mailing Address - Country:US
Mailing Address - Phone:561-703-5115
Mailing Address - Fax:
Practice Address - Street 1:1519 FENTON DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3555
Practice Address - Country:US
Practice Address - Phone:561-703-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 011547225100000X
FLPT011547251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K7187Medicare PIN