NPIMap

Florida Rehabilitation Specialist, LLC

Organization Active NPI Physical Therapist · Lady Lake, FL

NPI 1821040460 · NPPES record last updated Mar 5, 2015

Key facts

NPI
1821040460
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
FLORIDA REHABILITATION SPECIALIST, LLC
Practice address
134 N Old Dixie Hwy
Lady Lake, FL 32159-4347
Phone
(352) 751-6627
Fax
(352) 751-6628
NPI assigned
May 16, 2006
Organization subpart
No

Authorized official

Name
Artemio Dinal NPI 1750321097
Title
Physical Therapist
Phone
(352) 751-6627

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 10

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040623000274 FL Part B Supplier - Clinic/Group Practice 7012992076 Receives reassigned benefits from 3 practitioners
Practice locations: Lady Lake, FL

National Provider Directory

Locations

134 N Old Dixie Hwy
Lady Lake, FL 32159
Phone (352) 751-6627

134 N Old Dixie Hwy
Ste C
Lady Lake, FL 32159
Phone (352) 751-6627

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP		 225100000X FL Yes

Addresses

Primary practice location

134 N Old Dixie Hwy
Lady Lake, FL 32159-4347

Mailing address

134 N Old Dixie Hwy
Lady Lake, FL 32159-4347
Phone (352) 751-6627

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 5, 2015.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1821040460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N OLD DIXIE HWY",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594347",
            "telephone_number": "352-751-6627",
            "fax_number": "352-751-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N OLD DIXIE HWY",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594347",
            "telephone_number": "352-751-6627",
            "fax_number": "352-751-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA REHABILITATION SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "DINAL",
        "authorized_official_first_name": "ARTEMIO",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "352-751-6627"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

All providers in Lady Lake, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.