Provider Demographics
NPI:1194779306
Name:REHAB AXIS STAFFING AND MANAGEMENT, INC.
Entity type:Organization
Organization Name:REHAB AXIS STAFFING AND MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OSIAS
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:CADORNA
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPT
Authorized Official - Phone:941-320-8845
Mailing Address - Street 1:8466 LOCKWOOD RIDGE RD
Mailing Address - Street 2:#300
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2951
Mailing Address - Country:US
Mailing Address - Phone:941-359-2977
Mailing Address - Fax:
Practice Address - Street 1:255 COURTYARD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5794
Practice Address - Country:US
Practice Address - Phone:813-633-2887
Practice Address - Fax:813-864-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9705Medicare ID - Type UnspecifiedMEDICARE PART B