Provider Demographics
NPI:1720797228
Name:FWD REHAB & RECOVERY LLC
Entity Type:Organization
Organization Name:FWD REHAB & RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEAD PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:MOHAMAD
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:407-920-0892
Mailing Address - Street 1:462 N TERRY AVE APT 329
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2034
Mailing Address - Country:US
Mailing Address - Phone:407-920-0792
Mailing Address - Fax:
Practice Address - Street 1:462 N TERRY AVE APT 329
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2034
Practice Address - Country:US
Practice Address - Phone:407-920-0792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty