| Revive Rehab Inc | |
|
151 Sawgrass Corners Dr, Suite # 117, Ponte Vedra Beach, FL 32082-3553 | |
| (904) 472-8846 | |
| (888) 393-1099 |
| Full Name | Revive Rehab Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 151 Sawgrass Corners Dr, Ponte Vedra Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962734210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| Provider Name | Suzanne E Langenberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497737084 PECOS PAC ID: 5698702199 Enrollment ID: I20050726000508 |
| Provider Name | Darly Thoppil |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952633208 PECOS PAC ID: 4981733805 Enrollment ID: I20100622000105 |
| Provider Name | Laurie Scheer Berger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285931469 PECOS PAC ID: 9830372135 Enrollment ID: I20110324000053 |
| Provider Name | Seema W Bansal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134452469 PECOS PAC ID: 7810172376 Enrollment ID: I20110426000815 |
| Provider Name | David A Shelton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962485656 PECOS PAC ID: 0446205504 Enrollment ID: I20111214000864 |
| Provider Name | Robert Stephen Woodward |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013193143 PECOS PAC ID: 6800168089 Enrollment ID: I20170823001373 |
| Provider Name | Christine Maximos |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811451073 PECOS PAC ID: 8123452059 Enrollment ID: I20191230001967 |
| Provider Name | Dawn Lee Rudolph |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437769478 PECOS PAC ID: 4789009671 Enrollment ID: I20200810001866 |
| Provider Name | Tara Thompson Merlo |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497909527 PECOS PAC ID: 4587720347 Enrollment ID: I20220721000865 |
| Provider Name | Katerina Nicole Benedict |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255105466 PECOS PAC ID: 2264880665 Enrollment ID: I20231125000059 |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Rehab Inc 151 Sawgrass Corners Dr, Suite # 117, Ponte Vedra Beach, FL 32082-3553 Ph: (904) 472-8846 | Revive Rehab Inc 151 Sawgrass Corners Dr, Suite # 117, Ponte Vedra Beach, FL 32082-3553 Ph: (904) 472-8846 |
Emma Taormina, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 465 Town Plaza Ave Ste B, Ponte Vedra Beach, FL 32081 Phone: 904-222-3780 | |
Stephen Williamson, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 465 Town Plaza Ave Ste B, Ponte Vedra Beach, FL 32081 Phone: 904-222-3780 | |
Justin Stuart Gee Ming Ma, DPT, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 6 Fairfield Blvd, Ponte Vedra Beach, FL 32082 Phone: 904-996-6922 | |
Brian Wesley Gupton, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 880 A1a N, Ste 18a, Ponte Vedra Beach, FL 32082 Phone: 904-778-7501 Fax: 904-778-7504 | |
Jba South Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 13000 Sawgrass Village Cir Ste 14, Ponte Vedra Beach, FL 32082 Phone: 904-881-7612 Fax: 770-872-8294 | |
Robert Barnhard, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 117 Oak View Cir, Ponte Vedra Beach, FL 32082 Phone: 904-509-7643 | |
Mary Stuart Pratt, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 880 A1a N, Ste 18a, Ponte Vedra Beach, FL 32082 Phone: 904-778-7501 Fax: 904-778-7504 |