Healthcare Provider Details

I. General information

NPI: 1285951764
Provider Name (Legal Business Name): REHAB AFTER WORK OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

773 W LUMSDEN RD
BRANDON FL
33511-6261
US

IV. Provider business mailing address

5405 OKEECHOBEE BLVD SUITE 305
WEST PALM BEACH FL
33417-4543
US

V. Phone/Fax

Practice location:
  • Phone: 954-587-7771
  • Fax: 954-208-5770
Mailing address:
  • Phone: 954-587-7771
  • Fax: 954-208-5770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number1329AD743501
License Number StateFL

VIII. Authorized Official

Name: GUY MURRAY
Title or Position: CEO
Credential:
Phone: 954-587-7771