MEDICARE: 7520 REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor

General Provider Information

NPI Number	:	1134456684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	7520 REHABILITATION

Provider Business Mailing Address
First Line	:	7520 W WATERS AVE STE 14
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-1599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7520 W WATERS AVE STE 14
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-1599
Country	:	US
Telephone Number	:	813-443-4559
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELIGER ALFONSO
Credential	:
Telephone Number	:	813-443-4559

Provider Enumeration Date	:	11/04/2009
Last Update Date	:	11/04/2009

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