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General NPI Number Information
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NPI Number | 1568778876
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Entity Type | Organization
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Legal Business Name | SUPERIOR MEDICAL&REHAB CENTER
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 11911 OAK TRAIL WAY
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City | PORT RICHEY
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State | FL
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Zip | 34668-1064
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Country | US
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Telephone | 727-869-4999
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Fax | 727-869-4995
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Provider Business Mailing Address
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Address Line | 11911 OAK TRAIL WAY
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City | PORT RICHEY
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State | FL
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Zip | 34668-1064
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Country | US
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Telephone | 727-869-4999
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Fax | 727-869-4995
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Authorized Official
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Title or Position | CHIROPRATIC
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Name | MANUEL G RAMIREZ
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Credential | DC
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Telephone | 727-869-4999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | CH5539
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License Number State | FL
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