Provider Demographics
NPI:1548414857
Name:JETHWANI REHABILITATION GROUP INC
Entity Type:Organization
Organization Name:JETHWANI REHABILITATION GROUP INC
Other - Org Name:THERAPY FOR YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEENU
Authorized Official - Middle Name:
Authorized Official - Last Name:JETHWANI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L CLT
Authorized Official - Phone:352-732-4006
Mailing Address - Street 1:310 SE 29TH PL STE 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0486
Mailing Address - Country:US
Mailing Address - Phone:352-732-4006
Mailing Address - Fax:352-732-5006
Practice Address - Street 1:310 SE 29TH PL STE 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0486
Practice Address - Country:US
Practice Address - Phone:352-732-4006
Practice Address - Fax:352-732-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4799172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887854400Medicaid
FLK4081Medicare UPIN
FL887854400Medicaid