Provider Demographics
NPI:1003647900
Name:ATLANTIC REHABILITATION CENTER KNOXVILLE LLC
Entity type:Organization
Organization Name:ATLANTIC REHABILITATION CENTER KNOXVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAROCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:954-336-5639
Mailing Address - Street 1:16249 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4300
Mailing Address - Country:US
Mailing Address - Phone:954-336-5639
Mailing Address - Fax:305-405-0415
Practice Address - Street 1:9309 KINGSTON PIKE STE C
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2399
Practice Address - Country:US
Practice Address - Phone:954-336-5639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy