Provider Demographics
NPI:1083815286
Name:AVENTURA WELLNESS AND REHAB CENTER, INC.
Entity Type:Organization
Organization Name:AVENTURA WELLNESS AND REHAB CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-705-0777
Mailing Address - Street 1:2440 NE MIAMI GARDENS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2734
Mailing Address - Country:US
Mailing Address - Phone:305-705-0777
Mailing Address - Fax:305-705-9978
Practice Address - Street 1:2440 NE MIAMI GARDENS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2734
Practice Address - Country:US
Practice Address - Phone:305-705-0777
Practice Address - Fax:305-705-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL501515-1111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty