Organization
PHYSICAL MEDICINE & REHAB CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPHINE RACIMO ESTAMPADOR TAN MD (PRESIDENT)
(407) 931-1887
Entity
Organization
Contact information
Practice address
1125 N CENTRAL AVE, KISSIMMEE, FL 34741-4405
(407) 931-1887
(407) 931-2056
Mailing address
1125 N CENTRAL AVE, KISSIMMEE, FL 34741-4405
(407) 931-1887
(407) 931-2056
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME 60270
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371692900
—
FL
Enumeration date
11/04/2005
Last updated
04/23/2009
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