Organization

Gulf Coast Rehabilitation Services, Inc.

Legal Business Name

Gulf Coast Rehabilitation Services, Inc.

NPI Number

1447569264

NPI Type

Organization

Enumeration Date

09/28/2010

Specialties

(Taxonomies)

Code

101YA0400X
103K00000X
1041C0700X
101Y00000X
101YM0800X
101YP2500X
102L00000X
104100000X

Primary Taxonomy

No
No
No
No
No
No
No
No

Licenses

State

Florida
Florida
Florida

License Number

5525
SW7468
MH11189

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 13798
3825 HENDERSON BLVD

City

Tampa
Tampa

State

FL
FL

Postal Code

33681-3798
33629-5037

Country

US
US

Telephone Number

(877) 957-3422
(877) 957-3422

Authorized Official

Name

Dr. Joshua Shannon

Title or Position

CEO

Telephone Number

(877) 957-3422

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/19/2014

Provider Address