# INDEPENDENCE REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073536413
- **Authorized official:** MR. LUIS EDUARDO RODRIGUEZ PT (PHYSICAL THERAPY)
- **Authorized official phone:** (863) 409-6481

## Contact information

- **Practice address:** 5241 NICHOLS DR E, LAKELAND, FL 33813-4077
- **Practice address phone:** (863) 409-6481
- **Mailing address:** 5241 NICHOLS DR E, LAKELAND, FL 33813-4077
- **Mailing address phone:** (863) 409-6481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | PT7865 | FL | Yes |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 09/19/2007