OrganizationActive
Southern Advanced Rehabilitation Corp
NPI 1679956841 · Physical Medicine & Rehabilitation Physician · Tampa, FL
Provider details
- NPI number
- 1679956841
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jose Medina, President & Director(813) 986-4648
- License
- ME107516 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10723 Cory Lake Dr
Tampa, FL 33647-2725
Phone: (813) 986-4648
Fax: (813) 986-4648
Street-level locationGet directions
Mailing address
10723 Cory Lake Dr
Tampa, FL 33647-2725
Registry dates
- Enumerated
- 2015-07-07
- Last updated
- 2015-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.