MEDICARE: ST. JOSEPH REHABILITATION, 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	273Y00000X	Rehabilitation Hospital Unit	MM23642	FL

General Provider Information

NPI Number	:	1891020764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. JOSEPH REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	7825 N DALE MABRY HWY STE 104
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3207
Country	:	US
Telephone Number	:	813-443-5804
Fax Number	:	813-443-5805

Provider Business Practice Location Address
First Line	:	7825 N DALE MABRY HWY STE 104
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3207
Country	:	US
Telephone Number	:	813-443-5804
Fax Number	:	813-443-5805

Authorized Official
Title or Position	:	OWNER
Name	:	NAPTHALIE NARCISSE
Credential	:
Telephone Number	:	813-443-5804

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	10/12/2009

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