Provider Demographics
NPI:1124045836
Name:OCCUPATIONAL & PHYSICAL REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:OCCUPATIONAL & PHYSICAL REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-642-1332
Mailing Address - Street 1:300 SW 12TH AVE
Mailing Address - Street 2:SUITE 1B, 310-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2002
Mailing Address - Country:US
Mailing Address - Phone:305-642-1332
Mailing Address - Fax:305-642-1132
Practice Address - Street 1:300 SW 12TH AVE
Practice Address - Street 2:SUITE 1B, 310-B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2002
Practice Address - Country:US
Practice Address - Phone:305-642-1332
Practice Address - Fax:305-642-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684890Medicare ID - Type UnspecifiedMEDICARE PROVIDER #