Organization
BASELINE REHABILITATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
1400 S ORLANDO AVE, SUITE 207, WINTER PARK, FL 32789-5543
(407) 835-8818
(407) 835-8878
Mailing address
4714 GETTYSBURG RD, LEGAL DEPT, MECHANICSBURG, PA 17055-4325
(717) 972-1100
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2355952
AETNA HMO
FL
01
—
7346150
AETNA PPO
FL
Enumeration date
01/10/2007
Last updated
09/01/2010
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