| Organization Name: | FLORIDA THERAPY CENTER OF MELBOURNE LLC |
| NPI Number: | 1144288986 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATHEW SIMON KRONMAN (ADMINISTRATOR) |
| Mailing Address: | 520 Andros Ln Indian Harbour Beach |
| State: | FL US |
| Postal Code: | 329374403 |
| Phone Number: | 3218907439 |
| Fax Number: | 3217681710 |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 01/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0401X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Taxonomy Definition: | |