Clinicaid Well Center, LLC

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

License

HCC8834 Issued in FL

Legal business name

CLINICAID WELL CENTER, LLC

Practice address

3619 Henderson Blvd
Tampa, FL 33609-4501

Phone

(813) 874-2737

Fax

(813) 874-0099

NPI assigned

Jan 12, 2011

Organization subpart

No

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

Authorized official

Name

Sergio Ceballos, LMT

Title

Owner

Phone

(813) 874-2737

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1417252131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094501",
            "telephone_number": "813-874-2737",
            "fax_number": "813-874-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094501",
            "telephone_number": "813-874-2737",
            "fax_number": "813-874-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAID WELL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "CEBALLOS",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-874-2737",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "FL",
            "license": "HCC8834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Hospital Unit in Tampa, FL
• Providers in Tampa, FL by specialty
• Rehabilitation Hospital Unit in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.