Provider Demographics
NPI:1306146501
Name:INNOVATIVE REHAB SOLUTIONS INC.
Entity type:Organization
Organization Name:INNOVATIVE REHAB SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-600-4602
Mailing Address - Street 1:10465 NW 65TH DR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2915
Mailing Address - Country:US
Mailing Address - Phone:954-600-4602
Mailing Address - Fax:954-600-4602
Practice Address - Street 1:2825 N STATE ROAD 7
Practice Address - Street 2:SUITE 203
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-975-2007
Practice Address - Fax:954-979-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORT 56335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier