MEDICARE: HIGHLANDS REHAB INC.

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	225100000X	Physical Therapist	PT11083	FL

General Provider Information

NPI Number	:	1225357478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLANDS REHAB INC.

Provider Business Mailing Address
First Line	:	1030 US HIGHWAY 27 S
Second Line	:
City	:	AVON PARK
State	:	FL
Zip	:	33825-5114
Country	:	US
Telephone Number	:	863-382-8686
Fax Number	:	863-471-2976

Provider Business Practice Location Address
First Line	:	1030 US HIGHWAY 27 S
Second Line	:
City	:	AVON PARK
State	:	FL
Zip	:	33825-5114
Country	:	US
Telephone Number	:	863-382-8686
Fax Number	:	863-471-2976

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. NADIA PHILIP
Credential	:
Telephone Number	:	863-382-8686

Provider Enumeration Date	:	05/27/2010
Last Update Date	:	05/27/2010

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