Provider Demographics
NPI:1699728113
Name:UNITED CORF INC.
Entity type:Organization
Organization Name:UNITED CORF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, AIDE
Authorized Official - Phone:813-399-6889
Mailing Address - Street 1:7603 GUNN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625
Mailing Address - Country:US
Mailing Address - Phone:813-920-2444
Mailing Address - Fax:813-920-2444
Practice Address - Street 1:7603 GUNN HWY
Practice Address - Street 2:SUITE C
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625
Practice Address - Country:US
Practice Address - Phone:813-915-0692
Practice Address - Fax:813-915-8028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED CORF INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0401X
FLHCC6439261QR0401X, 283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684575Medicare PIN
FL684575Medicare Oscar/Certification