MEDICARE: REHABXPERIENCE 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	261QP2000X	Physical Therapy Clinic/Center	PT 0006687	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y080Q	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1922100767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABXPERIENCE LLC

Provider Business Mailing Address
First Line	:	350 NW 70TH AVE STE A
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2349
Country	:	US
Telephone Number	:	954-741-2221
Fax Number	:	954-741-2155

Provider Business Practice Location Address
First Line	:	350 NW 70TH AVE STE A
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2349
Country	:	US
Telephone Number	:	954-741-2221
Fax Number	:	954-741-2155

Authorized Official
Title or Position	:	MANAGING MEMBER AND CEO
Name	:	MR. OFER AMIT
Credential	:
Telephone Number	:	954-741-2221

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	10/05/2017

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Directions to “REHABXPERIENCE LLC ” Practice Location

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