Palm Bay Rehab Clinic Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

22797 Issued in FL

Legal business name

PALM BAY REHAB CLINIC INC

Practice address

3115 W Columbus Dr
Suite 109
Tampa, FL 33607-1865

Phone

(813) 374-9530

Fax

(813) 374-9541

NPI assigned

Mar 19, 2009

Organization subpart

No

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

Authorized official

Name

Miss Carrie C Tiziani

Title

Owner

Phone

(813) 374-9530

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1174764229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 W COLUMBUS DR",
            "address_2": "SUITE 109",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071865",
            "telephone_number": "813-374-9530",
            "fax_number": "813-374-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 W COLUMBUS DR",
            "address_2": "SUITE 109",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071865",
            "telephone_number": "813-374-9530",
            "fax_number": "813-374-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BAY REHAB CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "TIZIANI",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-374-9530",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "22797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.