MEDICARE: OPTIMAL REHAB, LLC

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	235Z00000X	Speech-Language Pathologist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1447441548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMAL REHAB, LLC

Provider Business Mailing Address
First Line	:	7319 BRIGHTWATER OAKS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4071
Country	:	US
Telephone Number	:	813-441-0173
Fax Number	:

Provider Business Practice Location Address
First Line	:	7319 BRIGHTWATER OAKS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-4071
Country	:	US
Telephone Number	:	813-441-0173
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ADRIAN F FLORENTINO
Credential	:
Telephone Number	:	727-776-7148

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/05/2007

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Directions to “OPTIMAL REHAB, LLC ” Practice Location

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