Advanced Rehab Center Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10247 Issued in FL

Legal business name

ADVANCED REHAB CENTER INC

Practice address

4401 S Hopkins Ave
Titusville, FL 32780-6679

Phone

(321) 383-0889

Fax

(321) 383-0898

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ehab Boulos, RPTNPI 1629184122

Title

President

Phone

(312) 383-0889

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ehab Boulos, RPT

  • Physical Therapist
  • Titusville, FL
  • NPI 1629184122
  Medicare reassignment NPD Authorized official
• Michael Ehab Boulos, DPT

  • Physical Therapist
  • Titusville, FL
  • NPI 1659186328
  Medicare reassignment NPD

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1730295247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806679",
            "telephone_number": "321-383-0889",
            "fax_number": "321-383-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S HOPKINS AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806679",
            "telephone_number": "321-383-0889",
            "fax_number": "321-383-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REHAB CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BOULOS",
        "authorized_official_first_name": "EHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-383-0889",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST HEALTH PLAN",
            "identifier": "16170.1",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSF",
            "identifier": "Y083U",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE",
            "identifier": "9407570",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CARE",
            "identifier": "23906",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelina Emma Marie Adams, COTA
• Noelle Sundrene Adderton
• Zeel Adeshra, MD
• Advanced Care Pediatrics of Florida, LLC
• Advanced Care Pediatrics, Inc.
• Affordable Dentures & Implants - Titusville, P.a.
• Deepak Aggarwal, RPH
• Aker Eye Center PA
• Carroll Gregory Aker, O.D.
• Roger Lee Alderman Jr., LMT

• Physical Therapist in Titusville, FL
• Providers in Titusville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.