Healthcare Provider Details

I. General information

NPI: 1023113503
Provider Name (Legal Business Name): FLOREHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N. NOVA ROAD
HOLLY HILL FL
32117-1737
US

IV. Provider business mailing address

915 N NOVA RD
HOLLY HILL FL
32117-4121
US

V. Phone/Fax

Practice location:
  • Phone: 386-671-2626
  • Fax: 386-671-2627
Mailing address:
  • Phone: 386-671-2626
  • Fax: 386-671-2627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 11414
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 11170
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 8095
License Number StateFL

VIII. Authorized Official

Name: ASAAD TAWFIK SAEED
Title or Position: OWNER/PHYSICAL THERAPIST
Credential:
Phone: 386-671-2626