MEDICARE: CENTRAL WEST THERAPY & 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	261Q00000X	Clinic/Center	HCC6444	FL

General Provider Information

NPI Number	:	1245335645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL WEST THERAPY & REHAB INC.

Provider Business Mailing Address
First Line	:	7211 N DALE MABRY HWY
Second Line	:	SUITE 215-216
City	:	TAMPA
State	:	FL
Zip	:	33614-2669
Country	:	US
Telephone Number	:	813-931-0908
Fax Number	:	813-931-8483

Provider Business Practice Location Address
First Line	:	7211 N DALE MABRY HWY
Second Line	:	SUITE 215-216
City	:	TAMPA
State	:	FL
Zip	:	33614-2669
Country	:	US
Telephone Number	:	813-931-0908
Fax Number	:	813-931-8483

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JORGE LUIS GARCES
Credential	:
Telephone Number	:	813-931-0908

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/22/2020

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