Provider Demographics
NPI:1679673594
Name:H2 REHABILITATION SERVICES OF FLORIDA LLC
Entity Type:Organization
Organization Name:H2 REHABILITATION SERVICES OF FLORIDA LLC
Other - Org Name:H2 HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STREETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-699-9395
Mailing Address - Street 1:484 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-4912
Mailing Address - Country:US
Mailing Address - Phone:800-699-9395
Mailing Address - Fax:
Practice Address - Street 1:1215 DUNN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-6330
Practice Address - Country:US
Practice Address - Phone:904-751-2000
Practice Address - Fax:904-751-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4532295OtherAETNA NON-HMO
FL8300209OtherCIGNA
FL8845212-23Medicaid
FL028580300Medicaid
FL102701OtherAVMED
FLQJ1OtherBCBS
FL160630529OtherDEPARTMENT OF LABOR
FL028580300Medicaid
FL8845212-23Medicaid
FL4827470014Medicare NSC