Healthcare Provider Details

I. General information

NPI: 1447489471
Provider Name (Legal Business Name): PRIME REHAB CENTER PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2009
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 CURLEW RD STE 7C
DUNEDIN FL
34698-9332
US

IV. Provider business mailing address

2323 CURLEW RD STE 7C
DUNEDIN FL
34698-9332
US

V. Phone/Fax

Practice location:
  • Phone: 727-512-6899
  • Fax:
Mailing address:
  • Phone: 727-512-6899
  • Fax: 727-284-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN HADDAD
Title or Position: CEO
Credential: DPT
Phone: 727-512-6899