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General NPI Number Information
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NPI Number | 1104925429
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Entity Type | Organization
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Legal Business Name | HEARTLAND REHABILITATION SERVICES OF FLORIDA LLC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 15260 NW 147TH DR
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City | ALACHUA
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State | FL
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Zip | 32615-5309
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Country | US
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Telephone | 386-462-4349
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Fax | 386-418-0824
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Provider Business Mailing Address
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Address Line | 540 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-4847
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Country | US
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Telephone | 904-264-2156
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Fax | 904-264-8350
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Authorized Official
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Title or Position | VICE PRESIDENT - REIMBURSEMENTS
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Name | MR. BARRY A LAZARUS
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Credential |
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Telephone | 419-252-5541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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