Provider Demographics
NPI:1396279865
Name:WEST FLORIDA REHABILITATION SPECIALISTS INC
Entity type:Organization
Organization Name:WEST FLORIDA REHABILITATION SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IMADUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-995-0984
Mailing Address - Street 1:10144 ARBOR RUN DR
Mailing Address - Street 2:UNIT 8
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3566
Mailing Address - Country:US
Mailing Address - Phone:813-995-0981
Mailing Address - Fax:813-280-6193
Practice Address - Street 1:10144 ARBOR RUN DR
Practice Address - Street 2:UNIT 8
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3566
Practice Address - Country:US
Practice Address - Phone:813-995-0981
Practice Address - Fax:813-280-6193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81192081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Single Specialty