MEDICARE: CAROLINA REHAB, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1073549754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA REHAB, INC.

Provider Business Mailing Address
First Line	:	50 E SAMPLE RD
Second Line	:	SUITE 301
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3552
Country	:	US
Telephone Number	:	954-938-3770
Fax Number	:	954-580-0921

Provider Business Practice Location Address
First Line	:	50 E SAMPLE RD
Second Line	:	SUITE 301
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3552
Country	:	US
Telephone Number	:	954-938-3770
Fax Number	:	954-580-0921

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM GUTHRIE
Credential	:
Telephone Number	:	954-938-3770

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	08/22/2020

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