Provider Demographics
NPI:1407127046
Name:RICHARD JOHN REJONIS II
Entity Type:Organization
Organization Name:RICHARD JOHN REJONIS II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:REJONIS
Authorized Official - Suffix:II
Authorized Official - Credentials:OTR/L, MS
Authorized Official - Phone:813-500-1553
Mailing Address - Street 1:11621 RENAISSANCE VIEW CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2683
Mailing Address - Country:US
Mailing Address - Phone:813-500-1553
Mailing Address - Fax:
Practice Address - Street 1:11621 RENAISSANCE VIEW CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2683
Practice Address - Country:US
Practice Address - Phone:813-500-1553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13708261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2323232323Medicare NSC