Advance Rehab Services P a
Organization Active NPI Specialist · Lauderhill, FL
NPI 1700902160 · NPPES record last updated Sep 1, 2022
Key facts
- NPI
- 1700902160
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- P.T. 0003694 (FL)
- Legal business name
- ADVANCE REHAB SERVICES P A
- Practice address
- 7471 W Oakland Park Blvd
Suite 103
Lauderhill, FL 33319-4921 - Phone
- (954) 748-7555
- Fax
- (954) 748-4910
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Sanjiv S Shah, R.P.T.
- Title
- Administrator
- Phone
- (954) 748-7555
Practitioners 3
-
Sanjiv S Shah, R.P.T.
-
Amrita D Jambhekar, OTR
-
Komal S Shah, R.P.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100901000201 | FL | Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 0547384372 | Practice locations: Lauderhill, FL |
National Provider Directory
Locations
7471 W Oakland Park Blvd
Ste 103
Tamarac, FL 33319
Phone (954) 748-7555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | P.T. 0003694 | FL | Yes |
Addresses
Primary practice location
7471 W Oakland Park Blvd
Suite 103
Lauderhill, FL 33319-4921
Mailing address
7471 W Oakland Park Blvd
Suite 103
Lauderhill, FL 33319-4921
Phone (954) 748-7555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 881552600 | Medicaid | FL |
Other providers in Lauderhill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.