Healthcare Provider Details

I. General information

NPI: 1073873600
Provider Name (Legal Business Name): HR HEALTHY REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7339 E COLONIAL DR SUITE 9
ORLANDO FL
32807-6380
US

IV. Provider business mailing address

7339 E COLONIAL DR SUITE 9
ORLANDO FL
32807-6380
US

V. Phone/Fax

Practice location:
  • Phone: 407-737-8700
  • Fax: 407-737-8711
Mailing address:
  • Phone: 407-737-8700
  • Fax: 407-737-8711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME67252
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5845
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA19539
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 64812
License Number StateFL

VIII. Authorized Official

Name: MS. FARATH DIAZ
Title or Position: OWNER
Credential:
Phone: 407-737-8700