Organization
PROGRESSIVE REHABILITATION AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD HAUPT PT (OWNER)
(941) 955-1239
Entity
Organization
Contact information
Practice address
2999 S TAMIAMI TRL, SARASOTA, FL 34239-5141
(941) 955-1239
(941) 955-1089
Mailing address
2999 S TAMIAMI TRL, SARASOTA, FL 34239-5141
(941) 955-1239
(941) 955-1089
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
106621
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R08
BCBS PROVIDER NUMBER
FL
Enumeration date
03/19/2007
Last updated
04/10/2015
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