Provider Demographics
NPI:1073825949
Name:ALL DADE REHAB & WELLNESS CENTER, L.L.C.
Entity Type:Organization
Organization Name:ALL DADE REHAB & WELLNESS CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSENHECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:754-368-0786
Mailing Address - Street 1:7175 SW 8TH ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4676
Mailing Address - Country:US
Mailing Address - Phone:305-603-7038
Mailing Address - Fax:305-603-7093
Practice Address - Street 1:7175 SW 8TH ST
Practice Address - Street 2:SUITE 213
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4676
Practice Address - Country:US
Practice Address - Phone:305-603-7038
Practice Address - Fax:305-603-7093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22560OtherBLUE CROSS BLUE SHIELD