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General NPI Number Information
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NPI Number | 1124160817
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Entity Type | Organization
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Legal Business Name | HOLLYWOOD INJURY REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 2544 N STATE ROAD 7
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3205
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Country | US
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Telephone | 954-963-1899
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Fax |
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Provider Business Mailing Address
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Address Line | 2544 N STATE ROAD 7
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3205
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Country | US
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Telephone | 954-963-1899
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT C LEWIN
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Credential | D.C.
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Telephone | 954-963-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | HCC5346
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License Number State | FL
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