Provider Demographics
NPI:1003155961
Name:KINETIC REHAB INC
Entity Type:Organization
Organization Name:KINETIC REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTROVIEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-201-1703
Mailing Address - Street 1:13349 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6544
Mailing Address - Country:US
Mailing Address - Phone:786-201-1703
Mailing Address - Fax:786-573-3619
Practice Address - Street 1:13349 SW 122ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6544
Practice Address - Country:US
Practice Address - Phone:786-201-1703
Practice Address - Fax:786-573-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty