MEDICARE: WEST FLORIDA ORTHOPEDIC REHABILITATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	2251H1200X	Hand Physical Therapist
2	2251X0800X	Orthopedic Physical Therapist
3	225100000X	Physical Therapist	FL

General Provider Information

NPI Number	:	1558456236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST FLORIDA ORTHOPEDIC REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 271681
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33688-1681
Country	:	US
Telephone Number	:	813-935-9355
Fax Number	:	813-932-3436

Provider Business Practice Location Address
First Line	:	3670 HENDERSON BLVD STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4515
Country	:	US
Telephone Number	:	813-877-6664
Fax Number	:	813-877-8799

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	PARINITA SHANTA SMITH
Credential	:	PT
Telephone Number	:	813-877-6664

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	08/02/2021

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