Provider Demographics
NPI:1760593842
Name:AQUATIC THERAPY AND REHABILITATION SERVICES INC
Entity Type:Organization
Organization Name:AQUATIC THERAPY AND REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:561-596-0906
Mailing Address - Street 1:6388 BRIDGEPORT LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6533
Mailing Address - Country:US
Mailing Address - Phone:561-596-0906
Mailing Address - Fax:561-966-3718
Practice Address - Street 1:499 E PALMETTO PARK RD
Practice Address - Street 2:STE 212
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5080
Practice Address - Country:US
Practice Address - Phone:561-596-0906
Practice Address - Fax:561-966-3718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4074Medicare ID - Type UnspecifiedPROVIDER NUMBER