Provider Demographics
NPI:1366077547
Name:RESURGENCE CARE, PLLC
Entity type:Organization
Organization Name:RESURGENCE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:MUNOZ
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:863-412-5479
Mailing Address - Street 1:PO BOX 1696
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33882-1696
Mailing Address - Country:US
Mailing Address - Phone:863-307-3005
Mailing Address - Fax:863-307-3005
Practice Address - Street 1:537 E CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3001
Practice Address - Country:US
Practice Address - Phone:863-307-3005
Practice Address - Fax:863-307-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty