Provider Demographics
NPI:1841527934
Name:FIRST CARE REHAB CENTER, LLC
Entity type:Organization
Organization Name:FIRST CARE REHAB CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LIUVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-597-8850
Mailing Address - Street 1:PO BOX 5806
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33758-5806
Mailing Address - Country:US
Mailing Address - Phone:727-216-6980
Mailing Address - Fax:727-216-6979
Practice Address - Street 1:1932 DREW ST
Practice Address - Street 2:SUITE 6
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3025
Practice Address - Country:US
Practice Address - Phone:727-216-6980
Practice Address - Fax:727-216-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM 23895261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy