MEDICARE: HEALTHY LIFE THERAPY AND 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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	684501	FL

General Provider Information

NPI Number	:	1578516472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY LIFE THERAPY AND REHAB INC

Provider Business Mailing Address
First Line	:	1860 N PINE ISLAND RD
Second Line	:	SUITE 111
City	:	PLANTATION
State	:	FL
Zip	:	33322-5239
Country	:	US
Telephone Number	:	954-916-8989
Fax Number	:	954-741-7706

Provider Business Practice Location Address
First Line	:	1860 N PINE ISLAND ROAD
Second Line	:	SUITE 111
City	:	PLANTATION
State	:	FL
Zip	:	33322-5233
Country	:	US
Telephone Number	:	954-916-8989
Fax Number	:	954-741-7706

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ARLENE ZWICKEL
Credential	:
Telephone Number	:	954-916-8989

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	09/03/2015

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