Healthcare Provider Details

I. General information

NPI: 1063044295
Provider Name (Legal Business Name): REHAB MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 LAKE ALFRED RD
WINTER HAVEN FL
33881-1435
US

IV. Provider business mailing address

3750 PRIORITY WAY SOUTH DR
INDIANAPOLIS IN
46240-3831
US

V. Phone/Fax

Practice location:
  • Phone: 863-595-1440
  • Fax: 866-699-8201
Mailing address:
  • Phone: 863-204-1320
  • Fax: 863-595-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: KEVIN GEARHEART
Title or Position: PRESIDENT
Credential:
Phone: 317-813-4210