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General NPI Number Information
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NPI Number | 1215228226
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC RESHABILITATION UNIT
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 1750 STOCKTON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4664
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Country | US
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Telephone | 904-308-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 STOCKTON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4664
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Country | US
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Telephone | 904-308-4700
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Fax |
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Authorized Official
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Title or Position | COO
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Name | GENE MIYAMOTO
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Credential |
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Telephone | 904-308-1290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1517096
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License Number State | FL
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