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Organization
INTERVENTIONAL REHABILITATION CENTER, LLC
Active
Organization
INTERVENTIONAL REHABILITATION CENTER, LLC
Active
Other names
Pensacola Children's Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN LARSEN (CEO)
(208) 340-1840
Entity
Organization
Contact information
Practice address
1549 AIRPORT BLVD, STE 420, PENSACOLA, FL 32504-8633
(850) 484-8800
(850) 484-6020
Mailing address
9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1216
(713) 489-2198
(713) 489-2978
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1061
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1061
LICENSE
FL
05
—
126892800
—
FL
Enumeration date
05/23/2005
Last updated
03/16/2026
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