Organization
IMPERIAL REHABILITATION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN E COOL OTR (PRESIDENT)
(321) 267-0500
Entity
Organization
Contact information
Practice address
813 CHENEY HWY, TITUSVILLE, FL 32780-6960
(321) 267-0500
Mailing address
813 CHENEY HWY, TITUSVILLE, FL 32780-6960
(321) 267-0500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3463
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z090L
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
01/08/2007
Last updated
08/22/2020
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