Provider Demographics
NPI:1073801122
Name:FERNANDEZ REHABILITATION CORP
Entity Type:Organization
Organization Name:FERNANDEZ REHABILITATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-381-2523
Mailing Address - Street 1:PO BOX 350593
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-0593
Mailing Address - Country:US
Mailing Address - Phone:305-381-2523
Mailing Address - Fax:305-392-1722
Practice Address - Street 1:9285 SW 125TH AVE
Practice Address - Street 2:206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7184
Practice Address - Country:US
Practice Address - Phone:305-381-2523
Practice Address - Fax:305-392-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation