Organization
AQUATIC HEALTH AND REHABILITATION SERVICES INC
Active
Other names
Aquatic Health and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
TEREASA DIANNE SHEPHERD P.T.,MSHA (PRESIDENT)
(321) 453-8484
Entity
Organization
Contact information
Practice address
595 N COURTENAY PKWY, #203, MERRITT ISLAND, FL 32953-4851
(321) 453-8484
(321) 453-8448
Mailing address
PO BOX 541210, MERRITT ISLAND, FL 32954-1210
(321) 453-8484
(321) 453-8448
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7742686
AETNA
FL
05
—
888029800
—
FL
01
—
9725170
GHI
FL
01
—
P00060639
RAILROAD MEDICARE
GA
01
—
Y904D
BCBS
FL
Enumeration date
09/14/2006
Last updated
07/24/2008
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