Healthcare Provider Details

I. General information

NPI: 1013126267
Provider Name (Legal Business Name): PERSONAL REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5124 N ARMENIA AVE
TAMPA FL
33603-1406
US

IV. Provider business mailing address

5124 N ARMENIA AVE
TAMPA FL
33603-1406
US

V. Phone/Fax

Practice location:
  • Phone: 813-304-1904
  • Fax: 813-304-1841
Mailing address:
  • Phone: 813-304-1904
  • Fax: 813-304-1841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberHCC7364
License Number StateFL

VIII. Authorized Official

Name: ARIEL SANTOS
Title or Position: OWNER
Credential:
Phone: 813-443-4742