Provider Demographics
NPI:1811149982
Name:REHAB SPECIALISTS INC. - WINTER HAVEN
Entity type:Organization
Organization Name:REHAB SPECIALISTS INC. - WINTER HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES
Authorized Official - Prefix:MR
Authorized Official - First Name:ACE STERLING
Authorized Official - Middle Name:ROXAS
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:863-678-9878
Mailing Address - Street 1:435 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4250
Mailing Address - Country:US
Mailing Address - Phone:863-678-9878
Mailing Address - Fax:863-678-9879
Practice Address - Street 1:435 S 11TH ST
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4250
Practice Address - Country:US
Practice Address - Phone:863-678-9878
Practice Address - Fax:863-678-9879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5986261QP2000X
FLOT5262261QP2000X
FLPT6404261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy