Provider Demographics
NPI:1093006025
Name:MANZUR REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:MANZUR REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:305-265-3267
Mailing Address - Street 1:1350 SW 57TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5775
Mailing Address - Country:US
Mailing Address - Phone:305-265-3267
Mailing Address - Fax:305-265-3267
Practice Address - Street 1:1350 SW 57TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5775
Practice Address - Country:US
Practice Address - Phone:305-265-3267
Practice Address - Fax:305-265-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 8738261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFILE 9055OtherAHCA EXEMPT HCC UNIT