Organization Active NPI

Personal Rehab Inc

  • Physical Medicine & Rehabilitation Physician
  • Lake Placid, FL
National Provider Identifier
1033173265
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT0005726 Issued in FL
Legal business name
PERSONAL REHAB INC
Practice address
104 S Main Ave
Lake Placid, FL 33852-1808
Phone
(863) 699-6929
NPI assigned
Apr 14, 2006
Last updated
Mar 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rene Smit, R.P.T.NPI 1831153949
Title
Owner
Phone
(863) 699-6929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT0005726 FL Primary

Addresses

Primary practice location

104 S Main Ave
Lake Placid, FL 33852-1808

Mailing address

104 S Main Ave
Lake Placid, FL 33852-1808
Phone (863) 699-6929

Other identifiers 2

IdentifierTypeStateIssuer
Y909EOtherFLBLUE CROSS BLUE SHIELD
DC0334OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

104 S Main Ave
Lake Placid, FL 33852
Phone (863) 699-6929

251 US 27 N
Sebring, FL 33870
Phone (863) 385-1406

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1033173265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S MAIN AVE",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338521808",
            "telephone_number": "863-699-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S MAIN AVE",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338521808",
            "telephone_number": "863-699-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "SMIT",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-699-6929",
        "authorized_official_credential": "R.P.T."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PT0005726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y909E",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC0334",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.