MEDICARE: ALLY REHAB, LLC

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
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1750244661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLY REHAB, LLC

Provider Business Mailing Address
First Line	:	5634 HILLVIEW CT
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3246
Country	:	US
Telephone Number	:	863-513-9054
Fax Number	:

Provider Business Practice Location Address
First Line	:	5634 HILLVIEW CT
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3246
Country	:	US
Telephone Number	:	863-513-9054
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JENNIFER HENSON SORIANO
Credential	:	DPT
Telephone Number	:	863-513-9054

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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