Organization
FLORIDA PHYSICAL THERAPY & REHABILITATIVE SERVICES INC
Active
Other names
Lake Centre for Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD GOLDSTEIN (VICE PRESIDENT)
(352) 728-6636
Entity
Organization
Contact information
Practice address
600 W NORTH BLVD, SUITE D, LEESBURG, FL 34748-5063
(352) 728-6636
(352) 787-4522
Mailing address
600 W NORTH BLVD, SUITE D, LEESBURG, FL 34748-5063
(352) 728-6636
(352) 787-4522
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R39
BCBS
FL
Enumeration date
11/28/2006
Last updated
04/22/2020
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