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Organization
MOMENTUM REHABILITATION LLC
Active
Organization
MOMENTUM REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BOGNER (OWNER)
(813) 352-1776
Entity
Organization
Contact information
Practice address
3501 BAYSHORE BLVD, TAMPA, FL 33629-8901
(813) 352-1776
Mailing address
3314 W CORONA ST, TAMPA, FL 33629-8007
(813) 352-1776
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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