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General NPI Number Information
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NPI Number | 1407228539
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Entity Type | Organization
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Legal Business Name | PHYSICIANS OF REHAB SERVICES LLC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 3105 GRAND AVE APT 401
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City | PINELLAS PARK
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State | FL
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Zip | 33782-6107
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Country | US
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Telephone | 608-216-4474
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Fax |
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Provider Business Mailing Address
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Address Line | 3105 GRAND AVE APT 401
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City | PINELLAS PARK
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State | FL
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Zip | 33782-6107
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Country | US
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Telephone | 561-926-5482
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Fax |
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Authorized Official
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Title or Position | OSTEOPATHIS PHYSICIAN
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Name | DR. SANDRA SANDHU
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Credential | D.O.
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Telephone | 561-926-5482
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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 | OS12890
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License Number State | FL
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