Organization
CENTRAL FLORIDA PHYSICAL MEDICINE AND REHABILITATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARET A MAIELLO (ADMIN)
(352) 365-9553
Entity
Organization
Contact information
Practice address
3261 US HIGHWAY 441/27 STE B2, FRUITLAND PARK, FL 34731-4492
(352) 365-9553
(352) 365-0205
Mailing address
PO BOX 490216, LEESBURG, FL 34749-0216
(352) 365-9553
(352) 365-0205
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259778100
—
FL
01
—
45486
BCBSFL GP NUMBER
FL
01
—
CH4936
PALMETTO GOVT (RAILROAD)
FL
Enumeration date
09/15/2005
Last updated
01/17/2018
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