Organization Name: | CORA HEALTH SERVICES INC |
NPI Number: | 1942352257 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRAD C ROUSH (EXECUTIVE VICE PRESIDENT) |
Mailing Address: | 11754 Martin Luther King Blvd Seffner |
State: | FL US |
Postal Code: | 335844923 |
Phone Number: | 8136618267 |
Fax Number: | 8136618715 |
NPI Enumeration Date: | 01/17/2007 |
NPI Last Update Date: | 09/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |