Healthcare Provider Details

I. General information

NPI: 1447580519
Provider Name (Legal Business Name): ALADDIN REHAB CENTER OF ST PETE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 ROOSEVELT BLVD N
ST PETERSBURG FL
33716-3816
US

IV. Provider business mailing address

1022 MAIN ST STE H
DUNEDIN FL
34698-5237
US

V. Phone/Fax

Practice location:
  • Phone: 727-577-3800
  • Fax: 727-578-5255
Mailing address:
  • Phone: 727-723-3000
  • Fax: 727-723-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. BEN ATKINS
Title or Position: CEO
Credential:
Phone: 727-224-9874