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General NPI Number Information
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NPI Number | 1225189525
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA CLINIC FOR REHABILITATION
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 5679 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7563
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Country | US
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Telephone | 352-795-4114
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Fax | 352-563-2438
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Provider Business Mailing Address
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Address Line | 5679 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7563
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Country | US
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Telephone | 352-795-4114
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Fax | 352-563-2438
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Authorized Official
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Title or Position | ADMINISTRATOR-OWNER
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Name | MRS. MADELINE GERRITS BROWN
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Credential | SCD,CCC-SP
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Telephone | 352-795-4114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | HCCR2624
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License Number State | FL
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