Provider Demographics
NPI:1164967832
Name:AMM REHABILITATION
Entity Type:Organization
Organization Name:AMM REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:410-487-1774
Mailing Address - Street 1:12157 NW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3311
Mailing Address - Country:US
Mailing Address - Phone:410-487-1774
Mailing Address - Fax:
Practice Address - Street 1:12330 SW 53RD ST
Practice Address - Street 2:#708
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-3319
Practice Address - Country:US
Practice Address - Phone:410-487-1774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT-24885208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty