MEDICARE: MORNING STAR 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1467560680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORNING STAR REHAB INC

Provider Business Mailing Address
First Line	:	6460 NW 5TH WAY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-6112
Country	:	US
Telephone Number	:	954-834-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6460 NW 5TH WAY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-6112
Country	:	US
Telephone Number	:	954-834-2222
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	DEBBIE MEDLEY
Credential	:
Telephone Number	:	727-786-5520

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	11/19/2008

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