INTERVENTIONAL REHABILITATION CENTER LLC NPI 1205839487

NPI Information

  • NPI: 1205839487
  • Provider Name: INTERVENTIONAL REHABILITATION CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 10D0938919
  • Address: 1549 AIRPORT BLVD
    STE 420
    PENSACOLA, FL
    ZIP 32504
  • Phone: (850) 484-8800

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NPI Details

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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)

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
1261QA1903XClinic/CenterAmbulatory Surgical1061FLORIDAYes

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
11061OTHERFLORIDALICENSE

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: 11/21/2025

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