PREMIER REHAB INC (NPI# 1467490136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467490136 |
| Entity Type | Organization |
| Organization Name | PREMIER REHAB INC |
| Other Organization Name | FYZICAL OF DAYTONA |
| Practice Address |
911 N Spring Garden Ave Deland FL 32720 |
| Mailing Address |
911 N Spring Garden Ave Deland FL 32720-2560 |
| Practice Telephone | 3867363108 |
| Practice Fax Number | 3867363643 |
| Mailing Telephone | 3867363108 |
| Mailing Fax Number | 3867363643 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-07-24 |
| Authorized Official Name | BARBARA ANNETTE DIVINCENZO (CEO) |
| Authorized Official Telephone | 3867363108 |
| Authorized Official Credential | OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | 2674 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS & BLUE SHIELD | R5L | 01 |
| FL | 681664996 | 05 | |
| FL | 882094500 | 05 |
| Other Name | Type Code |
|---|---|
| Fyzical of Daytona | Doing Business As Name - Organization |
| Fyzical of DeLand | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1510 Mason Ave, Daytona Beach, FL 321174549 | 3863172888 | 3867363643 |
| Street Address |
911 N SPRING GARDEN AVE |
| City | DELAND |
| State | FL |
| Zip Code | 32720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669017935 | Brandi Layne Koehler | Physical Therapist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2019-11-11 |
| 1306337225 | Justin Platt | Occupational Therapy Assistant | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2018-05-25 |
| 1568974509 | Daniel Christopher Wall | Speech-Language Pathologist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2017-10-31 |
| 1497208821 | Victoria Zern | Physical Therapy Assistant | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2016-08-02 |
| 1194100834 | Eric Mathis | Occupational Therapy Assistant | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2015-07-23 |
| 1043603152 | Jill Elizabeth Miller | Massage Therapist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2015-03-13 |
| 1942633037 | Cathy M Littlefield | Massage Therapist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2013-08-13 |
| 1902244296 | Fkellee Jolene Browning Ferrari | Massage Therapist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2013-06-07 |
| 1427316595 | Dana Leonard Murphy | Physical Therapist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2012-04-26 |
| 1013297993 | Charles Eugene Stewart | Acupuncturist | 911 N Spring Garden Ave, Deland, FL 32720-2560 | 2011-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171532 | Kimberlee C Del Campo | Nurse Practitioner | 1590 S, State Highway 15a, Deland, FL 32720 | 2020-10-13 |
| 1699304840 | Grace Haven LLC | In Home Supportive Care | 805 S Stone St, Deland, FL 32720 | 2020-04-08 |
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1548748957 | Christopher Lee Paik | Internal Medicine | 107 N Stone St, St A, Deland, FL 32720 | 2018-07-30 |
| 1164961041 | Melissa Sorensen | Counselor | 970 N Spring Ave, 523, Deland, FL 32720 | 2017-02-13 |
| 1669910329 | Stefanie Briann Yockey | Counselor | 804 N. Woodland Blvd., Deland, FL 32720 | 2017-02-02 |
| 1144648809 | Steven Shinn | Internal Medicine | 1590 S Sr 15a Ste 100, Deland, FL 32720 | 2014-03-31 |
| 1164843710 | Malgorzata Anna Szelwach | Occupational Therapist | 1590 State Rt 15a Suite B, Deland, FL 32720 | 2013-12-29 |
| 1730510926 | Adriana Marquez | Community/Behavioral Health | 33218 Tomahawk Trail, Deland, FL 32720 | 2013-12-12 |
| Find all providers in zip 32720 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770940652 | Solaris Rehab, LLC | Clinic/Center | 350 E International Speedway Blvd, Deland, FL 32724-2426 | 2016-01-22 |
| 1104858356 | Cora Health Services Inc | Clinic/Center | 1590 Sr 15a, Suite 2, Deland, FL 32720-7915 | 2006-07-07 |
| 1609179282 | Shc Rehab, LLC | Clinic/Center | 400 E Howry Ave, Deland, FL 32724 | 2010-12-21 |
| 1720316383 | Conficare Rehabilitation Solutions LLC | Clinic/Center | 400 E Howry Ave, Deland, FL 32724-5400 | 2009-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365496 | Cora Health Services, Inc. | Clinic/Center | 794 Blanding Blvd, Orange Park, FL 32065-5721 | 2020-10-29 |
| 1508466707 | A1a Physical Therapy, LLC | Clinic/Center | 8 Ocean Trace Rd, Saint Augustine, FL 32080-6972 | 2020-10-27 |
| 1891394078 | Rehabclinics Pta, Inc. | Clinic/Center | 12543 Miramar Pkwy, Miramar, FL 33027-2909 | 2020-10-20 |
| 1952918369 | Bayit Therapy LLC | Clinic/Center | 4699 N Federal Hwy Ste 101g, Pompano Beach, FL 33064-6510 | 2020-09-29 |
| 1205440815 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 3511 Vanderbilt Beach Rd, Naples, FL 34109-1342 | 2020-09-01 |
| 1275147043 | Sensei Medical Center Inc | Clinic/Center | 6500 W 4th Ave Ste 31, Hialeah, FL 33012-6606 | 2020-08-31 |
| 1649894361 | Yemaya Medical Center LLC | Clinic/Center | 2141 Sw 1st St Ste 206a, Miami, FL 33135-5603 | 2020-05-29 |
| 1336769801 | H2 Rehabilitation Services of Florida LLC | Clinic/Center | 484 Riverside Ave, Jacksonville, FL 32202-4912 | 2020-04-24 |
| 1649806787 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 111 N County Highway 393 Ste 201, Santa Rosa Beach, FL 32459-5366 | 2020-03-20 |
| 1366078032 | Cora Health Services, Inc. | Clinic/Center | 11420 Us Hwy 301 S, Riverview, FL 33578 | 2020-03-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PREMIER REHAB INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.