Provider Demographics
NPI:1891020764
Name:ST. JOSEPH REHABILITATION, INC.
Entity type:Organization
Organization Name:ST. JOSEPH REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAPTHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NARCISSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-443-5804
Mailing Address - Street 1:7825 N DALE MABRY HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3207
Mailing Address - Country:US
Mailing Address - Phone:813-443-5804
Mailing Address - Fax:813-443-5805
Practice Address - Street 1:7825 N DALE MABRY HWY STE 104
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3207
Practice Address - Country:US
Practice Address - Phone:813-443-5804
Practice Address - Fax:813-443-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM23642273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit