MEDICARE: NEUROLOGICAL REHABILITATION CENTER PROGRAM SERVICES

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	:	1588782957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGICAL REHABILITATION CENTER PROGRAM SERVICES

Provider Business Mailing Address
First Line	:	7777 N UNIVERSITY DR STE 101S
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-6106
Country	:	US
Telephone Number	:	954-722-2110
Fax Number	:	954-722-2304

Provider Business Practice Location Address
First Line	:	7777 N UNIVERSITY DR STE 101S
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-6106
Country	:	US
Telephone Number	:	954-722-2110
Fax Number	:	954-722-2304

Authorized Official
Title or Position	:	VP OPERATIONS
Name	:	MS. AYANA STEPHENSON
Credential	:	MBA
Telephone Number	:	954-722-2110

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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