Provider Demographics
NPI:1407228539
Name:PHYSICIANS OF REHAB SERVICES LLC
Entity Type:Organization
Organization Name:PHYSICIANS OF REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OSTEOPATHIS PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-926-5482
Mailing Address - Street 1:3105 GRAND AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-6107
Mailing Address - Country:US
Mailing Address - Phone:561-926-5482
Mailing Address - Fax:
Practice Address - Street 1:3105 GRAND AVE APT 401
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-6107
Practice Address - Country:US
Practice Address - Phone:608-216-4474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12890208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS12890OtherMEDICAL LICENSE