Provider Demographics
NPI:1609462829
Name:ACTIVE SOLUTIONS REHAB & WELLNESS LLC
Entity Type:Organization
Organization Name:ACTIVE SOLUTIONS REHAB & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINGENSCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:813-618-3316
Mailing Address - Street 1:12502 LOQUAT WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3048
Mailing Address - Country:US
Mailing Address - Phone:919-428-0383
Mailing Address - Fax:
Practice Address - Street 1:12502 LOQUAT WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3048
Practice Address - Country:US
Practice Address - Phone:919-428-0383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-13
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty