MEDICARE: VITAL REHAB INTERVENTION 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	225X00000X	Occupational Therapist	OT6356	FL
2	225100000X	Physical Therapist	PT0010934	FL

General Provider Information

NPI Number	:	1588755086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL REHAB INTERVENTION INC

Provider Business Mailing Address
First Line	:	PO BOX 236
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33780-0236
Country	:	US
Telephone Number	:	727-542-3580
Fax Number	:	727-548-6131

Provider Business Practice Location Address
First Line	:	10707 66TH ST N STE 14
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33782-2336
Country	:	US
Telephone Number	:	727-547-8600
Fax Number	:	727-548-6131

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MARIA TERESA PRESBITERO
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	727-804-2103

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	04/25/2020

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Directions to “VITAL REHAB INTERVENTION INC ” Practice Location

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