MEDICARE: SPORTS AND ORTHOPEDIC REHABILITATION SERVICES 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	261QP2000X	Physical Therapy Clinic/Center		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932109071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPORTS AND ORTHOPEDIC REHABILITATION SERVICES INC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DEPARTMENT
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:	717-975-9981

Provider Business Practice Location Address
First Line	:	3488 E LAKE RD
Second Line	:	SUITE 301
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2404
Country	:	US
Telephone Number	:	727-786-1996
Fax Number	:	727-789-2111

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JOHN F DUGGAN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	10/14/2025

Similar Medicare Providers

1831158872 — CHERYL M SALERNO OT
Practice Location Address:

3488 E LAKE RD , STE. 301
PALM HARBOR, FL
34685-2404

Practice Phone: 727-784-5261
Practice Fax:

1851350805 — MR. RANDY BRYAN WIEMER PT
Practice Location Address:

3488 E LAKE RD , SUITE 301
PALM HARBOR, FL
34685-2404

Practice Phone: 727-771-7377
Practice Fax:

1467404442 — LES D RUSKIN DC PA
Practice Location Address:

3488 E LAKE RD STE 102B
PALM HARBOR, FL
34685-2404

Practice Phone: 727-785-2545
Practice Fax: 727-781-0617

1881639086 — DONNA JEAN NOTHDURFT MS, OTR, CHT
Practice Location Address:

3488 E LAKE RD , SUITE 302
PALM HARBOR, FL
34685-2404

Practice Phone: 727-786-1996
Practice Fax: 727-789-2111

1467561175 — MR. DARREN JOSEPH BLOEBAUM PT
Practice Location Address:

3488 E LAKE RD , SUITE 302
PALM HARBOR, FL
34685-2404

Practice Phone: 727-771-7377
Practice Fax: 717-412-9851

1598887150 — DR. MAYUR JAYANTILAL MEHTA DDS.,MD.PA.
Practice Location Address:

3488 E LAKE RD , SUITE 401
PALM HARBOR, FL
34685-2404

Practice Phone: 727-785-7461
Practice Fax: 727-786-1065

Directions to “SPORTS AND ORTHOPEDIC REHABILITATION SERVICES INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.