Provider Demographics
NPI:1538331590
Name:ABILUTY REHABILITATION
Entity Type:Organization
Organization Name:ABILUTY REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OATES
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:321-217-3377
Mailing Address - Street 1:1337 S INTERNATIONAL PKWY STE 1321
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1402
Mailing Address - Country:US
Mailing Address - Phone:407-833-0802
Mailing Address - Fax:407-833-8931
Practice Address - Street 1:1337 S INTERNATIONAL PKWY STE 1321
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1402
Practice Address - Country:US
Practice Address - Phone:407-833-0802
Practice Address - Fax:407-833-8931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 21177261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy