Provider Demographics
NPI:1477966315
Name:LEGERITY REHAB, LLC
Entity Type:Organization
Organization Name:LEGERITY REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT &CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-365-3534
Mailing Address - Street 1:2033 MAIN ST
Mailing Address - Street 2:STE 302
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6056
Mailing Address - Country:US
Mailing Address - Phone:941-365-3534
Mailing Address - Fax:
Practice Address - Street 1:2033 MAIN ST
Practice Address - Street 2:STE 302
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6056
Practice Address - Country:US
Practice Address - Phone:941-365-3534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM13000005660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty