Healthcare Provider Details
I. General information
NPI: 1245284116
Provider Name (Legal Business Name): OCEAN REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2525 E FIRST ST
FORT MYERS FL
33901-2465
US
IV. Provider business mailing address
2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US
V. Phone/Fax
- Phone: 561-244-3627
- Fax: 561-244-0222
- Phone: 561-244-3627
- Fax: 561-244-0222
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MAXINE
HOCHHAUSER
Title or Position: CEO
Credential:
Phone: 561-244-0220