# SPORTS SPINE OCCUPATIONAL REHABILITATION INC

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

## Provider details

- **NPI number:** 1912191859
- **Authorized official:** JONATHAN TARRASH MD (OWNER)
- **Authorized official phone:** (561) 852-8636

## Contact information

- **Practice address:** 7015 BERACASA WAY STE 102, BOCA RATON, FL 33433-3453
- **Practice address phone:** (561) 295-3900
- **Practice address fax:** (561) 431-8288
- **Mailing address:** 10637 MENDOCINO LN, BOCA RATON, FL 33428-1229
- **Mailing address phone:** (561) 852-8636
- **Mailing address fax:** (561) 852-8672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2007
- **Last updated:** 10/22/2024