Provider Demographics
NPI:1598993032
Name:NEURO ORTHOPEDIC REHAB ASSOCIATES PLLC
Entity Type:Organization
Organization Name:NEURO ORTHOPEDIC REHAB ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-495-2773
Mailing Address - Street 1:4142 MARINER BLVD # 414
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2468
Mailing Address - Country:US
Mailing Address - Phone:352-684-5299
Mailing Address - Fax:352-688-8744
Practice Address - Street 1:12440 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-2628
Practice Address - Country:US
Practice Address - Phone:352-684-5299
Practice Address - Fax:352-688-8744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000682900Medicaid
FLI61044Medicare UPIN
FLCG449AMedicare PIN