| Florida Rehab Specialists, Pllc | |
|
300 Nw 1st Ave Williston FL 32696-2006 | |
| (561) 715-8673 | |
| Not Available |
| Full Name | Florida Rehab Specialists, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 300 Nw 1st Ave, Williston, Florida |
| Authorized Official Name and Position | Stefan Mann (PRESIDENT) |
| Authorized Official Contact | 5617158673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Rehab Specialists, Pllc 4122 Nw 128th Ter Gainesville FL 32606-4800 Ph: (561) 715-8673 | Florida Rehab Specialists, Pllc 300 Nw 1st Ave Williston FL 32696-2006 Ph: (561) 715-8673 |
| NPI Number | 1447941984 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 06/12/2024 |
| Medicare PECOS PAC ID | 5890155279 |
|---|---|
| Medicare Enrollment ID | O20230717002638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447941984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Robert L Griffin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629008073 PECOS PAC ID: 4385642453 Enrollment ID: I20061128000255 |
| Provider Name | Karen Elizabeth Valentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104197441 PECOS PAC ID: 4688838014 Enrollment ID: I20120614000201 |
| Provider Name | Joseph N Robbins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679951321 PECOS PAC ID: 1355657669 Enrollment ID: I20190131002821 |
| Provider Name | Leeanne Jessica Odum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659844306 PECOS PAC ID: 1951640986 Enrollment ID: I20190308000710 |
| Provider Name | Harish Kotipoyina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184157844 PECOS PAC ID: 0143593418 Enrollment ID: I20200928002619 |
| Provider Name | Stefan Samuel Mann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356847388 PECOS PAC ID: 0446504443 Enrollment ID: I20210811001851 |
| Provider Name | Holly Darlene Higdon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972272870 PECOS PAC ID: 3072900042 Enrollment ID: I20220420002813 |
| Provider Name | Ajitha Jickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437833688 PECOS PAC ID: 2567825318 Enrollment ID: I20230828002682 |
| Provider Name | Amy Swan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376314401 PECOS PAC ID: 4082156385 Enrollment ID: I20240601000221 |
| Provider Name | Angela Phan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043076805 PECOS PAC ID: 1254873375 Enrollment ID: I20240604004426 |
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