Organization
PROVIDENTIAL HEALTH & REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXIMIN VICTOR (MANAGER)
(407) 856-8584
Entity
Organization
Contact information
Practice address
5205 S ORANGE AVE STE 102, ORLANDO, FL 32809-3067
(407) 856-8584
Mailing address
5205 S ORANGE AVE STE 102, ORLANDO, FL 32809-3067
(407) 856-8584
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
HCC6145
FL
Other
Enumeration date
05/13/2007
Last updated
08/22/2020
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