Bernadette Rollins

Individual provider Active NPI Physical Therapist · Maitland, FL

NPI 1003165283 · NPPES record last updated Sep 5, 2012

Key facts

NPI
1003165283
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT1579 (FL)
Practice address
1301 W Maitland Blvd
Maitland, FL 32751-4338
Phone
(407) 645-3990
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT1579FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Living Rehabilitation Inc Physical Therapist Past
since Mar 1, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1579 FL Yes

Addresses

Primary practice location

1301 W Maitland Blvd
Maitland, FL 32751-4338

Mailing address

303 N Hurstbourne Pkwy Ste 200
Louisville, KY 40222-5158
Phone (502) 412-5847

Other providers in Maitland, FL

All providers in Maitland, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.