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NPI Code Detail

MEDICARE: IMPACT REHAB INC

MEDICARE: IMPACT 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
1225100000XPhysical TherapistPT 13318FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K3224OTHERFLMEDICARE

General Provider Information

NPI Number : 1134302532
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMPACT REHAB INC
Provider Business Mailing Address
First Line : 519 W 41ST ST
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-3509
Country : US
Telephone Number : 305-672-2992
Fax Number : 305-672-2913
Provider Business Practice Location Address
First Line : 519 W 41ST ST
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-3509
Country : US
Telephone Number : 305-672-2992
Fax Number : 305-672-2913
Authorized Official
Title or Position : PRESIDENT
Name : MR. ROBERT J MURDOCCO
Credential : P.T.
Telephone Number : 305-672-2992
Provider Enumeration Date : 12/10/2007
Last Update Date : 08/18/2010

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Directions to “IMPACT REHAB INC ” Practice Location

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