Organization
PERSONAL REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENE SMIT R.P.T. (OWNER)
(863) 699-6929
Entity
Organization
Contact information
Practice address
104 S MAIN AVE, LAKE PLACID, FL 33852-1808
(863) 699-6929
Mailing address
104 S MAIN AVE, LAKE PLACID, FL 33852-1808
(863) 699-6929
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT0005726
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0334
RAILROAD MEDICARE
FL
01
—
Y909E
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/14/2006
Last updated
03/23/2010
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