Provider Demographics
NPI:1710660493
Name:ROBERT'S REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:ROBERT'S REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HERNAN
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:II
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:305-785-3504
Mailing Address - Street 1:1166 SW GOODMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-1433
Mailing Address - Country:US
Mailing Address - Phone:305-785-3504
Mailing Address - Fax:
Practice Address - Street 1:1809 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5544
Practice Address - Country:US
Practice Address - Phone:305-785-3504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty