Organization
REHAB SPECIALITY CENTER LLC
Active
Organization
REHAB SPECIALITY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YSMARAY DIAZ LMT (OWNER)
(813) 506-4419
Entity
Organization
Contact information
Practice address
2112 W. MARTIN LUTHER KING JR. BLVD, TAMPA, FL 33607
(754) 303-6054
Mailing address
2112 W. MARTIN LUTHER KING JR. BLVD, TAMPA, FL 33607
(754) 303-6054
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MA62393
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA62393
LMT
FL
Enumeration date
08/09/2011
Last updated
07/21/2022
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