Healthcare Provider Details
I. General information
NPI: 1780989079
Provider Name (Legal Business Name): ADVANCED HAND AND REHAB CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2011
Last Update Date: 01/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4844 SUN N LAKE BLVD
SEBRING FL
33872-2110
US
IV. Provider business mailing address
4844 SUN N LAKE BLVD
SEBRING FL
33872-2110
US
V. Phone/Fax
- Phone: 863-991-3893
- Fax:
- Phone: 863-991-3893
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT13127 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OT7185 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | OT7185 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
ANANTHAN
SUNIL
KUMAR
Title or Position: PRESIDENT
Credential: OTR, CHT
Phone: 863-991-3893