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General NPI Number Information
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NPI Number | 1154574531
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Entity Type | Organization
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Legal Business Name | SUMMERFIELD REHABILITATION SPECIALISTS
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 17820 SE 109TH AVE SUITE 105B
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8968
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Country | US
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Telephone | 352-693-2152
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Fax |
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Provider Business Mailing Address
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Address Line | 17820 SE 109TH AVE SUITE 105B
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8968
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Country | US
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Telephone | 352-693-2152
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MANUEL R ZAYAS III
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Credential | RPT
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Telephone | 352-693-2152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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