| Organization Name: | PRODIGY HEALTHCARE SPECIALISTS, INC. |
| NPI Number: | 1497898688 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RACHEL K RELAO (PHYSICAL THERAPIST) |
| Mailing Address: | 2823 Us Highway 301 N Ste. 4 Ellenton |
| State: | FL US |
| Postal Code: | 342222084 |
| Phone Number: | 9417298600 |
| Fax Number: | 9417294440 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT11333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |