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General NPI Number Information
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NPI Number | 1790305209
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Entity Type | Organization
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Legal Business Name | JAKUBOWSKI SPORTS REHABILITATION, LLC
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 1085 BELLE AVE
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-2961
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Country | US
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Telephone | 407-718-0437
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Fax | 321-710-7185
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Provider Business Mailing Address
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Address Line | 4370 DAUBERT STREET
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City | ORLANDO
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State | FL
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Zip | 32803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | RACHEL JAKUBOWSKI
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Credential | PT, DPT, SCS
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Telephone | 407-718-0437
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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 |
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License Number State |
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