Healthcare Provider Details

I. General information

NPI: 1659478873
Provider Name (Legal Business Name): TBC REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4517 CLARKWOOD CT
LAND O LAKES FL
34639-4094
US

IV. Provider business mailing address

4517 CLARKWOOD CT
LAND O LAKES FL
34639-4094
US

V. Phone/Fax

Practice location:
  • Phone: 813-600-3327
  • Fax: 813-600-5614
Mailing address:
  • Phone: 813-600-3327
  • Fax: 813-600-5614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: FERMIN ROLAND ROTEA
Title or Position: CO-OWNER
Credential: PT
Phone: 813-600-3327