Provider Demographics
NPI:1740453455
Name:ABILITY REHABILITATION
Entity type:Organization
Organization Name:ABILITY REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:BORDEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:386-532-5003
Mailing Address - Street 1:1130 N OLD MILL DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-2823
Mailing Address - Country:US
Mailing Address - Phone:386-532-5003
Mailing Address - Fax:
Practice Address - Street 1:1130 N OLD MILL DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-2823
Practice Address - Country:US
Practice Address - Phone:386-532-5003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA18487261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy