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General NPI Number Information
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NPI Number | 1245382043
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Entity Type | Organization
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Legal Business Name | FLORIDA INJURY AND REHAB
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1520 N JOHN YOUNG PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34741-3219
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Country | US
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Telephone | 407-518-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 N JOHN YOUNG PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34741-3219
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Country | US
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Telephone | 407-518-7700
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MR. DAUWD BASIYR MEDAN
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Credential | PA-C
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Telephone | 407-518-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME69749
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License Number State | FL
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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 | ME69749
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License Number State | FL
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