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General NPI Number Information
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NPI Number | 1114096575
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Entity Type | Organization
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Legal Business Name | MEDICAL REHABILITATION SPECIALISTS II INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1803 MICCOSUKEE COMMONS DR STE202
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City | TALAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone | 850-402-0200
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Fax | 850-402-0564
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Provider Business Mailing Address
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Address Line | PO BOX 12578
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City | TALAHASSEE
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State | FL
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Zip | 32317-2578
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Country | US
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Telephone | 850-402-0200
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Fax | 850-402-0564
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | KIRK J MAURO
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Credential |
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Telephone | 850-402-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | HCC5556
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License Number State | FL
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