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Organization
OCEAN ONE ENTERPRISES
Active
Organization
OCEAN ONE ENTERPRISES
Active
Other names
VARSITY REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK MCVINNEY (REHAB DIRECTOR)
(386) 677-4300
Entity
Organization
Contact information
Practice address
495 S NOVA RD STE 113, ORMOND BEACH, FL 32174-8470
(386) 677-4300
(386) 615-9216
Mailing address
495 S NOVA RD STE 113, ORMOND BEACH, FL 32174-8470
(386) 677-4300
(386) 615-9216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0002188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699893
GHI
FL
01
—
5132624
AETNA
FL
01
—
650015987
MC RAIL ROAD
FL
01
—
PT2188
PT LICENCE
FL
Enumeration date
11/30/2006
Last updated
02/09/2021
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