Provider Demographics
NPI:1104358266
Name:GAMA REHAB SERVICES, INC
Entity Type:Organization
Organization Name:GAMA REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:305-803-3165
Mailing Address - Street 1:19042 NW 91ST CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-8418
Mailing Address - Country:US
Mailing Address - Phone:305-803-3165
Mailing Address - Fax:
Practice Address - Street 1:14411 COMMERCE WAY STE 230
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1598
Practice Address - Country:US
Practice Address - Phone:305-625-8844
Practice Address - Fax:305-803-3165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency