Provider Demographics
NPI:1447389861
Name:CENTER FOR ORTHOPEDIC & SPINE REHABILITATION, INC.
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPEDIC & SPINE REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-362-9748
Mailing Address - Street 1:7200 W CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5511
Mailing Address - Country:US
Mailing Address - Phone:561-362-9748
Mailing Address - Fax:561-362-8059
Practice Address - Street 1:7200 W CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5511
Practice Address - Country:US
Practice Address - Phone:561-362-9748
Practice Address - Fax:561-362-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 4363261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy