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General NPI Number Information
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NPI Number | 1902188782
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Entity Type | Organization
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Legal Business Name | WELLNESS REHAB SERVICES INC
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 6550 SAN AUGUSTIN RD STE 304
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City | JACKSONVILLE
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State | FL
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Zip | 32217
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Country | US
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Telephone | 813-369-1136
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Fax |
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Provider Business Mailing Address
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Address Line | 6550 SAN AUGUSTINE RD STE 304
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City | JACKSONVILLE
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State | FL
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Zip | 32217
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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
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Name | JORGE RODRIGUEZ
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Credential |
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Telephone | 813-369-1136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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