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General NPI Number Information
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NPI Number | 1144637018
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Entity Type | Organization
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Legal Business Name | 1ST CLASS PHYSICAL MEDICINE AND REHABILITATION
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Dates
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Enumeration Date | 07/12/2014
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 2275 SW 22ND LN
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City | OCALA
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State | FL
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Zip | 34471-7710
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Country | US
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Telephone | 352-387-9889
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Fax |
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Provider Business Mailing Address
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Address Line | 2141 NE 2ND ST
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City | OCALA
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State | FL
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Zip | 34470-6950
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Country | US
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Telephone | 419-573-2505
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA MARIE ALVAREZ PEREZ
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Credential | M.D.
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Telephone | 419-573-2505
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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 | ME124242
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License Number State | FL
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