Provider Demographics
NPI:1396869160
Name:EHAB REHAB, INC. DBA APEX PHYSICAL THERAPY
Entity type:Organization
Organization Name:EHAB REHAB, INC. DBA APEX PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPISTS
Authorized Official - Prefix:MR
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABDELMALEK
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:904-389-2077
Mailing Address - Street 1:4558 SAN JUAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-2051
Mailing Address - Country:US
Mailing Address - Phone:904-389-2077
Mailing Address - Fax:904-381-0543
Practice Address - Street 1:4558 SAN JUAN AVE STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2051
Practice Address - Country:US
Practice Address - Phone:904-389-2077
Practice Address - Fax:904-381-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16803174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty