Healthcare Provider Details
I. General information
NPI: 1447203948
Provider Name (Legal Business Name): H2 REHABILITATION SERVICES OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 11/19/2023
Certification Date: 11/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
96279 BRADY POINT RD SUITE B
FERNANDINA BEACH FL
32034-7076
US
IV. Provider business mailing address
PO BOX 932184
ATLANTA GA
31193-2184
US
V. Phone/Fax
- Phone: 904-261-7878
- Fax: 904-261-8466
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
STREETER
Title or Position: VICE PRESIDENT
Credential:
Phone: 800-699-9395