Provider Demographics
NPI:1750955985
Name:KANDO REHAB LLC
Entity type:Organization
Organization Name:KANDO REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MERRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:813-541-1872
Mailing Address - Street 1:777 N ASHLEY DR UNIT 3209
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4387
Mailing Address - Country:US
Mailing Address - Phone:813-541-1872
Mailing Address - Fax:
Practice Address - Street 1:777 N ASHLEY DR UNIT 3209
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4387
Practice Address - Country:US
Practice Address - Phone:813-541-1872
Practice Address - Fax:813-441-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty