Provider Demographics
NPI:1881804292
Name:DOCTOR FLORIDA REHABILITATION, INC.
Entity type:Organization
Organization Name:DOCTOR FLORIDA REHABILITATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTENIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-873-2000
Mailing Address - Street 1:PO BOX 4979
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33677-4979
Mailing Address - Country:US
Mailing Address - Phone:813-873-2000
Mailing Address - Fax:813-873-2006
Practice Address - Street 1:2123 W MLK BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6545
Practice Address - Country:US
Practice Address - Phone:813-873-2000
Practice Address - Fax:813-873-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5678261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service