Provider Demographics
NPI:1164764411
Name:PALMETTO REHABILITATION SERVICES, INC
Entity Type:Organization
Organization Name:PALMETTO REHABILITATION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:SAUL
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-301-4464
Mailing Address - Street 1:12420 SW 192ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3800
Mailing Address - Country:US
Mailing Address - Phone:786-301-4464
Mailing Address - Fax:786-429-1701
Practice Address - Street 1:7805 CORAL WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6539
Practice Address - Country:US
Practice Address - Phone:786-301-4464
Practice Address - Fax:786-429-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service