Provider Demographics
NPI:1447257027
Name:REHAB DYNAMICS INC.
Entity type:Organization
Organization Name:REHAB DYNAMICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:DEYOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-492-4100
Mailing Address - Street 1:1531 TAMIAMI TRL S
Mailing Address - Street 2:STE 702B
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-5569
Mailing Address - Country:US
Mailing Address - Phone:941-492-4100
Mailing Address - Fax:941-492-4144
Practice Address - Street 1:1531 TAMIAMI TRL S
Practice Address - Street 2:STE 702B
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-5569
Practice Address - Country:US
Practice Address - Phone:941-492-4100
Practice Address - Fax:941-492-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686613Medicare ID - Type UnspecifiedMEDICARE