Provider Demographics
NPI:1164800595
Name:SOBE INNOVATIVE REHABILITATION PLLC
Entity Type:Organization
Organization Name:SOBE INNOVATIVE REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NKUME
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPT
Authorized Official - Phone:585-354-3847
Mailing Address - Street 1:3029 NE 188TH ST APT 1110
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2874
Mailing Address - Country:US
Mailing Address - Phone:585-354-3847
Mailing Address - Fax:
Practice Address - Street 1:21005 NE 19TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1511
Practice Address - Country:US
Practice Address - Phone:585-354-3847
Practice Address - Fax:305-397-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty