Provider Demographics
NPI:1982801783
Name:REHAB PHYSICIANS LLC
Entity Type:Organization
Organization Name:REHAB PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-345-9615
Mailing Address - Street 1:3152 LITTLE RD
Mailing Address - Street 2:# 162
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1864
Mailing Address - Country:US
Mailing Address - Phone:727-376-6578
Mailing Address - Fax:727-376-6784
Practice Address - Street 1:1609 PASADENA AVE S
Practice Address - Street 2:# 3 - H
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4565
Practice Address - Country:US
Practice Address - Phone:727-345-9615
Practice Address - Fax:727-345-9635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7604Medicare PIN
FLDD8350Medicare PIN
FLG77050Medicare UPIN