MEDICARE: MBH REHABILITATION 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	8047	FL
2	225X00000X	Occupational Therapist	5319	FL
3	225100000X	Physical Therapist	8004	FL

General Provider Information

NPI Number	:	1245236694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MBH REHABILITATION INC

Provider Business Mailing Address
First Line	:	7491 RIDGEFIELD LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7329
Country	:	US
Telephone Number	:	561-436-9595
Fax Number	:	561-439-7595

Provider Business Practice Location Address
First Line	:	7491 RIDGEFIELD LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7329
Country	:	US
Telephone Number	:	561-436-9595
Fax Number	:	561-439-7595

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MR. BAHER F HABIB
Credential	:	RPT
Telephone Number	:	561-436-9595

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/26/2010

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