Provider Demographics
NPI:1154301992
Name:METRO MED CARE REHAB INC
Entity Type:Organization
Organization Name:METRO MED CARE REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTIGUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-470-0124
Mailing Address - Street 1:7884 NW 52ND ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4742
Mailing Address - Country:US
Mailing Address - Phone:305-470-0124
Mailing Address - Fax:305-470-0154
Practice Address - Street 1:7884 NW 52ND ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4742
Practice Address - Country:US
Practice Address - Phone:305-470-0124
Practice Address - Fax:305-470-0154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
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
FL684884Medicare Oscar/Certification