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General NPI Number Information
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NPI Number | 1699866988
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Entity Type | Organization
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Legal Business Name | REHAB 1OF CHARLOTTE COUNTY, INC.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 4166 TAMIAMI TRL SUITE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9209
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Country | US
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Telephone | 941-766-1110
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Fax | 941-766-1190
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Provider Business Mailing Address
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Address Line | 4166 TAMIAMI TRL SUITE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9209
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Country | US
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Telephone | 941-766-1110
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Fax | 941-766-1190
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CHRISTINE HIZON
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Credential |
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Telephone | 941-766-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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