Provider Demographics
NPI:1477647766
Name:FIT REHAB & CONSULTANTS INC
Entity type:Organization
Organization Name:FIT REHAB & CONSULTANTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-271-2530
Mailing Address - Street 1:1311 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-9301
Mailing Address - Country:US
Mailing Address - Phone:561-271-2530
Mailing Address - Fax:888-627-2451
Practice Address - Street 1:900 E INDIANTOWN RD STE 100
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5142
Practice Address - Country:US
Practice Address - Phone:888-627-2325
Practice Address - Fax:888-627-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686705Medicare Oscar/Certification