MEDICARE: SOLUTION MEDICAL REHABILITATION

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	MM28041	FL

General Provider Information

NPI Number	:	1366788523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLUTION MEDICAL REHABILITATION

Provider Business Mailing Address
First Line	:	3980 TAMPA RD
Second Line	:	SUIT#204
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3223
Country	:	US
Telephone Number	:	813-336-4926
Fax Number	:	813-336-4930

Provider Business Practice Location Address
First Line	:	3980 TAMPA RD
Second Line	:	SUIT#204
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3223
Country	:	US
Telephone Number	:	813-336-4926
Fax Number	:	813-336-4930

Authorized Official
Title or Position	:	MANAGER
Name	:	ISRAEL ALONSO
Credential	:
Telephone Number	:	813-336-4926

Provider Enumeration Date	:	12/17/2012
Last Update Date	:	12/17/2012

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