Provider Demographics
NPI:1154363331
Name:MEDAMERICA REHAB CENTER INC.
Entity type:Organization
Organization Name:MEDAMERICA REHAB CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-428-4707
Mailing Address - Street 1:3275 W. MILLSBORO BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9476
Mailing Address - Country:US
Mailing Address - Phone:954-428-4707
Mailing Address - Fax:954-698-9314
Practice Address - Street 1:3275 W MILLSBORO BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9476
Practice Address - Country:US
Practice Address - Phone:954-428-4707
Practice Address - Fax:954-698-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106911Medicare UPIN
FL106911Medicare ID - Type UnspecifiedMEDICARE
FLA06911Medicare UPIN