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Organization
FLORIDA THERAPY CENTER OF MELBOURNE LLC
Active
Organization
FLORIDA THERAPY CENTER OF MELBOURNE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATHEW SIMON KRONMAN MPT (ADMINISTRATOR)
(321) 890-7439
Entity
Organization
Contact information
Practice address
635 S WICKHAM RD STE 103, MELBOURNE, FL 32904-1436
(321) 890-7439
(321) 768-1710
Mailing address
635 S WICKHAM RD STE 103, MELBOURNE, FL 32904-1436
(321) 890-7439
(321) 768-1710
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GF7
BCBS PROVIDER NUMBER
FL
Enumeration date
05/02/2006
Last updated
08/10/2023
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