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General NPI Number Information
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NPI Number | 1134335557
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Entity Type | Organization
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Legal Business Name | COCONUT CREEK REHABILITATION INC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 4915 COCONUT CREEK PKWY
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City | COCONUT CREEK
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State | FL
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Zip | 33063-3909
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Country | US
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Telephone | 954-972-1200
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Fax | 954-972-6212
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Provider Business Mailing Address
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Address Line | 4915 COCONUT CREEK PKWY
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City | COCONUT CREEK
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State | FL
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Zip | 33063-3909
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Country | US
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Telephone | 954-972-1200
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Fax | 954-972-6212
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Authorized Official
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Title or Position | PRESIDENT
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Name | TODD R JAMES
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Credential | PT
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Telephone | 954-972-1200
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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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