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General NPI Number Information
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NPI Number | 1871580969
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Entity Type | Organization
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Legal Business Name | MEDICAL REHABILITATION ASSOCIATES, INC PC
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 6086 AUBURN CT
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City | BURLINGTON
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State | KY
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Zip | 41005-8022
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Country | US
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Telephone | 304-809-5312
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Fax | 410-250-7756
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Provider Business Mailing Address
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Address Line | 1964 HOWELL BRANCH RD STE 108
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City | WINTER PARK
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State | FL
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Zip | 32792-1042
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Country | US
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Telephone | 407-681-2241
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Fax | 407-279-6779
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARL RANDOLPH SHELTON
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Credential | MD
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Telephone | 304-809-5312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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