Provider Demographics
NPI:1578373189
Name:HOHMAN REHAB AND SPORTS THERAPY
Entity type:Organization
Organization Name:HOHMAN REHAB AND SPORTS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:REAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-404-6908
Mailing Address - Street 1:11095 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2976
Mailing Address - Country:US
Mailing Address - Phone:407-347-8936
Mailing Address - Fax:352-404-6909
Practice Address - Street 1:11095 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2976
Practice Address - Country:US
Practice Address - Phone:407-347-8936
Practice Address - Fax:352-404-6909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003281201Medicaid