MEDICARE: TOTAL FITNESS & REHABILITAION 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	225100000X	Physical Therapist	5501004460	MI

General Provider Information

NPI Number	:	1760552426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL FITNESS & REHABILITAION LLC

Provider Business Mailing Address
First Line	:	40030 CARINI DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-5373
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 W AUBURN RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-5002
Country	:	US
Telephone Number	:	248-844-8248
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROHAN KARUNANAYAKE
Credential	:
Telephone Number	:	586-354-7109

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	08/22/2020

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