Healthcare Provider Details
I. General information
NPI: 1730134214
Provider Name (Legal Business Name): STARR SPORTS REHABILITATION AND PHYSICAL THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14265 POWELL ROAD
SPRING HILL FL
34606-8280
US
IV. Provider business mailing address
14265 POWELL ROAD
SPRING HILL FL
34606-8280
US
V. Phone/Fax
- Phone: 352-799-9329
- Fax:
- Phone: 352-799-9329
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STACEY
GARCIA
Title or Position: OWNER
Credential: PHYSICAL THERAPIST
Phone: 352-799-9329