Healthcare Provider Details

I. General information

NPI: 1255943288
Provider Name (Legal Business Name): LUTZ REHAB AND HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19091 N DALE MABRY HWY
LUTZ FL
33548-4982
US

IV. Provider business mailing address

1000 GATES AVE
BROOKLYN NY
11221-6295
US

V. Phone/Fax

Practice location:
  • Phone: 813-751-0557
  • Fax:
Mailing address:
  • Phone: 718-852-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: RACHEL SCHUSTER
Title or Position: CORPORATE ADMINISTRATOR
Credential: LNHA
Phone: 305-458-3835