Provider Demographics
NPI:1871945477
Name:SHARITY REHAB
Entity type:Organization
Organization Name:SHARITY REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSR
Authorized Official - Prefix:
Authorized Official - First Name:SHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-212-1410
Mailing Address - Street 1:11127 SAVANNAH LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5108
Mailing Address - Country:US
Mailing Address - Phone:407-212-1410
Mailing Address - Fax:
Practice Address - Street 1:11127 SAVANNAH LANDING CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5108
Practice Address - Country:US
Practice Address - Phone:407-212-1410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid