INTERVENTIONAL REHABILITATION CENTER LLC NPI 1205839487

NPI Information

NPI: 1205839487
Provider Name: INTERVENTIONAL REHABILITATION CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 10D0938919

Address:
1549 AIRPORT BLVD
STE 420
PENSACOLA, FL
ZIP 32504
Phone: (850) 484-8800
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INTERVENTIONAL REHABILITATION CENTER, LLC is an ambulatory surgical clinic center in Pensacola, FL. INTERVENTIONAL REHABILITATION CENTER, LLC NPI is 1205839487. The provider is registered as an organization entity type.

The provider's business location address is:

1549 AIRPORT BLVD
STE 420
PENSACOLA, FL
ZIP 32504-633
Phone: (850) 484-8800
Fax: (850) 484-6020

The provider's authorized official is Ruben Berrocal Timmons .
The authorized official title is Medical Director/administrator and has the following contact phone number (850) 484-8800.

The CLIA number assigned to this NPI record is 10D0938919 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	1061	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1061	OTHER	FLORIDA	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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