Genesis Rehab Services

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PTA 24415 Issued in FL

Legal business name

GENESIS REHAB SERVICES

Practice address

1120 West Donegan Ave.
Keystone Rehab Center
Kissimmee, FL 34741

Phone

(407) 201-7749

NPI assigned

Feb 26, 2015

Last updated

Feb 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Hector R De Jesus, LPTA

Title

Physical Therapist Assistant

Phone

(407) 201-7749

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1629460761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 JEREMIAH WAY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347433718",
            "telephone_number": "757-816-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 WEST DONEGAN AVE.",
            "address_2": "KEYSTONE REHAB CENTER",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-201-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REHAB SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "407-201-7749",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "PTA 24415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gencare Kids, LLC
• General Behavior Analysis LLC
• Genesis Health Development, Inc. (Brooks Health Development)
• Genesis Healthcare Services
• Genesis International Medical Services LLC
• Genoa Healthcare LLC
• Gensis Rehab Services
• Sherrine George
• Vanessa Maria Geraci, M.S. CF-SLP
• Ria Gerard, RN

• Assisted Living Facility in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.