Provider Demographics
NPI:1437260494
Name:SPRING HILL REHAB AND LYMPHEDEMA CENTER
Entity Type:Organization
Organization Name:SPRING HILL REHAB AND LYMPHEDEMA CENTER
Other - Org Name:ULTIMATE HAND AND LYMPHEDEMA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:352-593-4919
Mailing Address - Street 1:17222 HOSPITAL BLVD
Mailing Address - Street 2:SUITE 346
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-8925
Mailing Address - Country:US
Mailing Address - Phone:352-593-4919
Mailing Address - Fax:352-796-3323
Practice Address - Street 1:12587 SPRING HILL DRIVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609
Practice Address - Country:US
Practice Address - Phone:352-593-4919
Practice Address - Fax:352-796-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQZ3OtherBCBS
FL686639Medicare Oscar/Certification
FL5706980001Medicare NSC