Provider Demographics
NPI:1154379816
Name:TOTAL HEALTH AND REHAB CENTER
Entity type:Organization
Organization Name:TOTAL HEALTH AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MINETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-482-7575
Mailing Address - Street 1:8903 GLADES RD
Mailing Address - Street 2:A-11
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4074
Mailing Address - Country:US
Mailing Address - Phone:561-482-7575
Mailing Address - Fax:561-482-7724
Practice Address - Street 1:8903 GLADES RD
Practice Address - Street 2:A-11
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4074
Practice Address - Country:US
Practice Address - Phone:561-482-7575
Practice Address - Fax:561-482-7724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251X0800X
FLCH7498111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381300200Medicaid
FLK1766Medicare PIN
FL381300200Medicaid