MEDICARE: ATLAS REHABILITATION 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1255797924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS REHABILITATION LLC

Provider Business Mailing Address
First Line	:	692 BEAR CREEK CT
Second Line	:
City	:	WINTER SPGS
State	:	FL
Zip	:	32708-3858
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	692 BEAR CREEK CT
Second Line	:
City	:	WINTER SPGS
State	:	FL
Zip	:	32708-3858
Country	:	US
Telephone Number	:	407-542-3250
Fax Number	:

Authorized Official
Title or Position	:	PT/OWNER
Name	:	JAMES ADISANO
Credential	:
Telephone Number	:	407-542-3250

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	01/11/2016

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Directions to “ATLAS REHABILITATION LLC ” Practice Location

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