Provider Demographics
NPI:1225444375
Name:LAKES REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:LAKES REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:305-819-2439
Mailing Address - Street 1:8060 NW 155TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5883
Mailing Address - Country:US
Mailing Address - Phone:305-819-2439
Mailing Address - Fax:305-819-2139
Practice Address - Street 1:8060 NW 155TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5883
Practice Address - Country:US
Practice Address - Phone:305-819-2439
Practice Address - Fax:305-819-2139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center