Provider Demographics
NPI:1801094172
Name:RESTORE THERAPY SERVICES OF FLORIDA LLC
Entity type:Organization
Organization Name:RESTORE THERAPY SERVICES OF FLORIDA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:800-379-0309
Mailing Address - Street 1:245 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2216
Mailing Address - Country:US
Mailing Address - Phone:800-379-0309
Mailing Address - Fax:205-314-7233
Practice Address - Street 1:1055 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4101
Practice Address - Country:US
Practice Address - Phone:386-252-3686
Practice Address - Fax:386-255-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation