Organization
FLORIDA THERAPY CENTER OF MELBOURNE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATHEW SIMON KRONMAN MPT (ADMINISTRATOR)
(321) 890-7439
Entity
Organization
Contact information
Practice address
635 S WICKHAM RD STE 103, MELBOURNE, FL 32904-1436
(321) 890-7439
(321) 768-1710
Mailing address
635 S WICKHAM RD STE 103, MELBOURNE, FL 32904-1436
(321) 890-7439
(321) 768-1710
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GF7
BCBS PROVIDER NUMBER
FL
Enumeration date
05/02/2006
Last updated
08/10/2023
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