Provider Demographics
NPI:1881849719
Name:OPUS PHYSICAL REHABILITATION & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:OPUS PHYSICAL REHABILITATION & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ZELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BISSELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:561-756-4112
Mailing Address - Street 1:5010 PRAIRIE DUNES VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8214
Mailing Address - Country:US
Mailing Address - Phone:561-756-4112
Mailing Address - Fax:
Practice Address - Street 1:5010 PRAIRIE DUNES VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-8214
Practice Address - Country:US
Practice Address - Phone:561-756-4112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21279174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT21279OtherLICENSE