Provider Demographics
NPI:1376662593
Name:BAY AREA INJURY REHAB SPECIALISTS HOLDINGS INC
Entity type:Organization
Organization Name:BAY AREA INJURY REHAB SPECIALISTS HOLDINGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:MAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-930-8454
Mailing Address - Street 1:PO BOX 272450
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-2450
Mailing Address - Country:US
Mailing Address - Phone:813-930-8454
Mailing Address - Fax:
Practice Address - Street 1:11801 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3505
Practice Address - Country:US
Practice Address - Phone:813-930-8454
Practice Address - Fax:813-930-9554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty