MEDICARE: BACK TO HEALTH REHAB CENTER 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	261QH0100X	Health Service Clinic/Center	HCC9457	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356600068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK TO HEALTH REHAB CENTER INC

Provider Business Mailing Address
First Line	:	3015 S CONGRESS AVE
Second Line	:	SUITE 1
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2111
Country	:	US
Telephone Number	:	561-444-3490
Fax Number	:	561-444-3491

Provider Business Practice Location Address
First Line	:	3015 S CONGRESS AVE
Second Line	:	SUITE 1
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2111
Country	:	US
Telephone Number	:	561-444-3490
Fax Number	:	561-444-3491

Authorized Official
Title or Position	:	OWNER
Name	:	YORDANY MARTINEZ
Credential	:
Telephone Number	:	561-444-3490

Provider Enumeration Date	:	05/15/2012
Last Update Date	:	12/07/2020

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