Provider Demographics
NPI:1154574531
Name:SUMMERFIELD REHABILITATION SPECIALISTS
Entity type:Organization
Organization Name:SUMMERFIELD REHABILITATION SPECIALISTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZAYAS
Authorized Official - Suffix:III
Authorized Official - Credentials:RPT
Authorized Official - Phone:352-693-2152
Mailing Address - Street 1:17820 SE 109TH AVE
Mailing Address - Street 2:SUITE 105B
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8968
Mailing Address - Country:US
Mailing Address - Phone:352-693-2152
Mailing Address - Fax:
Practice Address - Street 1:17820 SE 109TH AVE
Practice Address - Street 2:SUITE 105B
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8968
Practice Address - Country:US
Practice Address - Phone:352-693-2152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty