Healthcare Provider Details

I. General information

NPI: 1407922735
Provider Name (Legal Business Name): THE VILLAGES REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N US HIGHWAY 441 BUILDING 800, SUITE 830
LADY LAKE FL
32159-8975
US

IV. Provider business mailing address

PO BOX 491313
LEESBURG FL
34749-1313
US

V. Phone/Fax

Practice location:
  • Phone: 352-753-6999
  • Fax: 352-259-0002
Mailing address:
  • Phone: 352-728-6636
  • Fax: 352-787-4522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. GERALD GOLDSTEIN
Title or Position: VICE PRES
Credential:
Phone: 352-728-6636