Organization
SOUTHERN ADVANCED REHABILITATION CORP
Active
Organization
SOUTHERN ADVANCED REHABILITATION CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE MANUEL MEDINA M.D. (PRESIDENT & DIRECTOR)
(813) 986-4648
Entity
Organization
Contact information
Practice address
10723 CORY LAKE DR, TAMPA, FL 33647-2725
(813) 986-4648
(813) 986-4648
Mailing address
10723 CORY LAKE DR, TAMPA, FL 33647-2725
(813) 986-4648
(813) 986-4648
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME107516
FL
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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