=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548324221
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIGUEROA AND COLINA REHABILITATION SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 03/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 SE OCEAN BLVD SUITE 244 BLDG E
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34994-2471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-223-4563
-----------------------------------------------------
Fax | 772-223-4567
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 SE OCEAN BLVD SUITE 244 BLDG E
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34994-2471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-223-4563
-----------------------------------------------------
Fax | 772-223-4567
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. FERNANDO FIGUEROA
-----------------------------------------------------
Credential | P.T., DPT, PH.D.,
-----------------------------------------------------
Telephone | 772-223-4563
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | PT9798
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | PT6978
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------