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General NPI Number Information
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NPI Number | 1457582702
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Entity Type | Organization
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Legal Business Name | NEW THERAPY REHAB
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 1901 DOOMAR DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4805
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Country | US
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Telephone | 786-543-1632
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 DOOMAR DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4805
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Country | US
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Telephone | 786-543-1632
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERICK URRA
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Credential |
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Telephone | 786-543-1632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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