Provider Demographics
NPI:1114384146
Name:ANDREU REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:ANDREU REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUNIOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREU SIBERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-704-2968
Mailing Address - Street 1:7235 CORAL WAY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1466
Mailing Address - Country:US
Mailing Address - Phone:786-704-2968
Mailing Address - Fax:
Practice Address - Street 1:7235 CORAL WAY
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1466
Practice Address - Country:US
Practice Address - Phone:786-704-2968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13681261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center