Provider Demographics
NPI:1588800528
Name:M&R THERAPY CENTER INC
Entity Type:Organization
Organization Name:M&R THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELEYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NADAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-877-6900
Mailing Address - Street 1:4150 N ARMENIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6448
Mailing Address - Country:US
Mailing Address - Phone:813-877-6900
Mailing Address - Fax:813-877-6941
Practice Address - Street 1:4150 N ARMENIA AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-877-6900
Practice Address - Fax:813-877-6941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7493302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization