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General NPI Number Information
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NPI Number | 1922404243
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Entity Type | Organization
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Legal Business Name | REHABILITATION AND FITNESS CONSULTANTS, PLLC
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3208 E COLONIAL DR UNIT 299
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City | ORLANDO
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State | FL
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Zip | 32803-5127
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Country | US
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Telephone | 321-325-7792
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Fax | 321-352-7559
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Provider Business Mailing Address
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Address Line | 3208 E COLONIAL DR UNIT 299
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City | ORLANDO
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State | FL
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Zip | 32803-5127
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Country | US
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Telephone | 321-325-7792
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Fax | 321-352-7559
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS E HENDERSON
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Credential | MD
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Telephone | 443-804-6723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME120324
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License Number State | FL
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