Provider Demographics
NPI:1922208479
Name:PHYSICAL MEDICINE & REHAB ASSOCIATES
Entity Type:Organization
Organization Name:PHYSICAL MEDICINE & REHAB ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-255-4708
Mailing Address - Street 1:PO BOX 490957
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-0957
Mailing Address - Country:US
Mailing Address - Phone:352-255-4708
Mailing Address - Fax:216-255-5186
Practice Address - Street 1:3371 WEDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-7181
Practice Address - Country:US
Practice Address - Phone:352-255-4708
Practice Address - Fax:216-255-5186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43158Medicare PIN