Organization Name: | BWELL REHAB LLC |
NPI Number: | 1306260161 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARINA VISHNEVSKY (PRESIDENT) |
Mailing Address: | 405 Commercial Ct Ste A Venice |
State: | FL US |
Postal Code: | 342921653 |
Phone Number: | 9414849291 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2014 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ6600 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |