Provider Demographics
NPI:1497930713
Name:LEGEND MEDICAL & REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:LEGEND MEDICAL & REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SERAFIN
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:MENECIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:407-692-8859
Mailing Address - Street 1:1400 N SEMORAN BLVD STE A
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3562
Mailing Address - Country:US
Mailing Address - Phone:407-692-8859
Mailing Address - Fax:
Practice Address - Street 1:1400 N SEMORAN BLVD STE A
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3562
Practice Address - Country:US
Practice Address - Phone:407-692-8859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-05
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6368261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service