MEDICARE: REHABDYNAMICS, LLC

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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1154504249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABDYNAMICS, LLC

Provider Business Mailing Address
First Line	:	4205 TWIN PALM LN
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32904-9582
Country	:	US
Telephone Number	:	371-722-5994
Fax Number	:	371-722-5978

Provider Business Practice Location Address
First Line	:	8085 SPYGLASS HILL RD
Second Line	:
City	:	VIERA
State	:	FL
Zip	:	32940-7984
Country	:	US
Telephone Number	:	321-751-6771
Fax Number	:	321-751-6798

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TERRI A. RINES
Credential	:
Telephone Number	:	371-722-5994

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	12/11/2007

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