Provider Demographics
NPI:1447251947
Name:VENICE REHAB, LLC
Entity type:Organization
Organization Name:VENICE REHAB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-210-5622
Mailing Address - Street 1:2203 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5016
Mailing Address - Country:US
Mailing Address - Phone:941-408-0670
Mailing Address - Fax:941-408-0160
Practice Address - Street 1:2203 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5016
Practice Address - Country:US
Practice Address - Phone:941-408-0670
Practice Address - Fax:941-408-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
FLPT19740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9AOtherBLUE CROSS PROVIDER NUMBE
FLRAILROAD MEDICAREOther650009877
FLRAILROAD MEDICAREOther650009877