Healthcare Provider Details

I. General information

NPI: 1245275387
Provider Name (Legal Business Name): HOME REHAB SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W LAKE MARY BLVD SUITE 213
LAKE MARY FL
32746-3501
US

IV. Provider business mailing address

2500 W LAKE MARY BLVD SUITE 213
LAKE MARY FL
32746-3501
US

V. Phone/Fax

Practice location:
  • Phone: 321-277-1983
  • Fax: 407-386-6132
Mailing address:
  • Phone: 321-277-1983
  • Fax: 407-386-6132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT21068
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT9735
License Number StateFL

VIII. Authorized Official

Name: MR. JAMES JONATHAN INDA
Title or Position: MANAGING PARTNER
Credential: OTR/L
Phone: 321-277-1983