Healthcare Provider Details

I. General information

NPI: 1619697182
Provider Name (Legal Business Name): PANHANDLE MEDICAL AND REHABILITATION SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4402
US

IV. Provider business mailing address

PO BOX 14523
TALLAHASSEE FL
32317-4523
US

V. Phone/Fax

Practice location:
  • Phone: 850-325-5000
  • Fax: 850-325-5198
Mailing address:
  • Phone: 219-662-3931
  • Fax: 219-663-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT D ROWLAND
Title or Position: OWNER
Credential: MD
Phone: 219-662-3931