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Contact Information

ATLANTIC COAST MEDICAL REHAB
13171 ATLANTIC BLVD. SUITE #100
JACKSONVILLE, FL32225
 Phone: 904-888-6095
 Fax: 904-280-5238
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for ATLANTIC COAST MEDICAL REHAB · (Female)

NPI Number 1104115112
Status Active
Credentials
Entity Individual
Enumeration date 03/30/2011
Last updated 06/29/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME79945
  • FL Other 001KM BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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