Provider Demographics
NPI:1407016868
Name:DIMAB REHAB INC
Entity Type:Organization
Organization Name:DIMAB REHAB INC
Other - Org Name:SPECIAL CARE CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-633-1300
Mailing Address - Street 1:1726 NW 36TH ST
Mailing Address - Street 2:UNIT 12
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5433
Mailing Address - Country:US
Mailing Address - Phone:305-633-1300
Mailing Address - Fax:305-633-1301
Practice Address - Street 1:1726 NW 36TH ST
Practice Address - Street 2:UNIT 12
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5433
Practice Address - Country:US
Practice Address - Phone:305-633-1300
Practice Address - Fax:305-633-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686670Medicare Oscar/Certification