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General NPI Number Information
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NPI Number | 1649599168
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Entity Type | Organization
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Legal Business Name | RESTORATIVE HEALTH REHABILITATION INC
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 2042 NE 8TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-4702
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Country | US
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Telephone | 786-410-5394
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Fax |
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Provider Business Mailing Address
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Address Line | 18701 SW 291ST TER
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City | HOMESTEAD
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State | FL
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Zip | 33030-3014
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Country | US
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Telephone | 786-410-5394
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GREGG FISKE
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Credential |
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Telephone | 786-410-5394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | PT 15371
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License Number State | FL
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