ATLANTIC COAST MEDICAL REHAB; NPI #1104115112

Contact Information

ATLANTIC COAST MEDICAL REHAB

13171 ATLANTIC BLVD. SUITE #100
JACKSONVILLE, FL 32225

Phone: 904-888-6095
Fax: 904-280-5238
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Specialist	174400000X

Indicates primary specialty

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NPI Profile & details for ATLANTIC COAST MEDICAL REHAB

NPI Number 1104115112

LBN Legal business name ATLANTIC COAST MEDICAL REHAB

Authorized official TRACI ROSENSTEIN - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/30/2011

Last updated 06/29/2020 - About 6 years ago

Identifiers

FL	License #	ME79945
FL	Other	001KM	BLUE CROSS BLUE SHIELD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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