| Organization Name: | SPORTS & ORTHOPEDIC REHABILITATION SERVICES INC |
| NPI Number: | 1720132616 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL TARVIN (VICE PRESIDENT) |
| Mailing Address: | 4655 66th St N Number 22b Kenneth City |
| State: | FL US |
| Postal Code: | 337094827 |
| Phone Number: | 7275464700 |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 04/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |