MEDICARE: SELECT MEDICAL CORPORATION

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	17757	FL

General Provider Information

NPI Number	:	1225586928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	13801 WALSINGHAM RD STE G
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33774-3237
Country	:	US
Telephone Number	:	727-593-7909
Fax Number	:

Provider Business Practice Location Address
First Line	:	13801 WALSINGHAM RD STE G
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33774-3237
Country	:	US
Telephone Number	:	727-593-7909
Fax Number	:

Authorized Official
Title or Position	:	MARKET MANAGER
Name	:	DAVID BROWN
Credential	:
Telephone Number	:	727-593-7909

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	09/12/2016

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