Provider Demographics
NPI:1558312843
Name:REHAB & THERAPY INC
Entity Type:Organization
Organization Name:REHAB & THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:H
Authorized Official - Last Name:FORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:561-912-9580
Mailing Address - Street 1:6860 NW 73RD ST
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3916
Mailing Address - Country:US
Mailing Address - Phone:561-912-9580
Mailing Address - Fax:561-912-9506
Practice Address - Street 1:1886 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1417
Practice Address - Country:US
Practice Address - Phone:954-427-6606
Practice Address - Fax:954-427-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19852225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY917SOtherBLUE CROSS BLUE SHIELD
FL5779050001Medicare NSC
FLK7493Medicare PIN