Provider Demographics
NPI:1356004295
Name:QUALITY PAIN AND REHAB LLC
Entity Type:Organization
Organization Name:QUALITY PAIN AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:FIALLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-923-0484
Mailing Address - Street 1:19339 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7603
Mailing Address - Country:US
Mailing Address - Phone:305-259-5995
Mailing Address - Fax:
Practice Address - Street 1:19339 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7603
Practice Address - Country:US
Practice Address - Phone:305-259-5995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty