# REBORN THERAPY CENTER

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

## Provider details

- **NPI number:** 1205327921
- **Authorized official:** CARMEN M MELENDEZ BA (DIRECTOR)
- **Authorized official phone:** (407) 350-4805

## Contact information

- **Practice address:** 4710 W IRLO BRONSON MEMORIAL HWY, KISSIMMEE, FL 34746-5325
- **Practice address phone:** (321) 337-9391
- **Mailing address:** 4710 W IRLO BRONSON MEMORIAL HWY, KISSIMMEE, FL 34746-5325
- **Mailing address phone:** (407) 350-4805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | NULL | Yes |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/29/2018
- **Last updated:** 09/08/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 025078600 | — | FL |