Healthcare Provider Details

I. General information

NPI: 1780139006
Provider Name (Legal Business Name): INFINITY REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 11/02/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 GLENFIELD CT
APOPKA FL
32712-2378
US

IV. Provider business mailing address

PO BOX 2763
APOPKA FL
32704-2763
US

V. Phone/Fax

Practice location:
  • Phone: 386-235-8576
  • Fax:
Mailing address:
  • Phone: 386-235-8576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT10897
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA9883
License Number StateFL

VIII. Authorized Official

Name: MR. DAMON T. GIVENS
Title or Position: CO-OWNER
Credential: OTR/L
Phone: 386-453-1726