Provider Demographics
NPI:1265710149
Name:MEDREHAB SPECIALISTS PA
Entity type:Organization
Organization Name:MEDREHAB SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREJON
Authorized Official - Suffix:
Authorized Official - Credentials:DO,
Authorized Official - Phone:404-596-5599
Mailing Address - Street 1:303 PERIMETER CTR N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-3402
Mailing Address - Country:US
Mailing Address - Phone:404-596-5599
Mailing Address - Fax:888-508-2509
Practice Address - Street 1:303 PERIMETER CTR N
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-3402
Practice Address - Country:US
Practice Address - Phone:404-596-5599
Practice Address - Fax:888-508-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003115372AMedicaid
GADS1707OtherRAIL ROAD MEDICARE
GADS1707OtherRAIL ROAD MEDICARE