Provider Demographics
NPI:1013044973
Name:ELITE REHABILITATION
Entity Type:Organization
Organization Name:ELITE REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:305-836-4345
Mailing Address - Street 1:600 E 25TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3801
Mailing Address - Country:US
Mailing Address - Phone:305-836-4345
Mailing Address - Fax:305-836-5904
Practice Address - Street 1:600 E 25TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3801
Practice Address - Country:US
Practice Address - Phone:305-836-4345
Practice Address - Fax:305-836-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT11494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP65186Medicare UPIN
FLE7864AMedicare ID - Type UnspecifiedPROVIDER MEDICARE NUMBER
FLK7626Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER