Provider Demographics
NPI:1477848364
Name:ROMAIN REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:ROMAIN REHABILITATION CENTER, LLC
Other - Org Name:NEURO FIT 360
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:954-383-1366
Mailing Address - Street 1:10062 GRIFFIN ROAD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328
Mailing Address - Country:US
Mailing Address - Phone:954-252-8020
Mailing Address - Fax:954-241-6991
Practice Address - Street 1:10062 GRIFFIN ROAD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328
Practice Address - Country:US
Practice Address - Phone:954-252-8020
Practice Address - Fax:954-241-6991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-19
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 21838261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8917329 00Medicaid