Provider Demographics
NPI:1467722637
Name:ADRIAN REHAB MOBILE
Entity Type:Organization
Organization Name:ADRIAN REHAB MOBILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CANGAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-234-7889
Mailing Address - Street 1:19251 SW 134 AVE RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177
Mailing Address - Country:US
Mailing Address - Phone:786-234-7889
Mailing Address - Fax:305-238-4717
Practice Address - Street 1:19251 SW 134 AVE RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177
Practice Address - Country:US
Practice Address - Phone:786-234-7889
Practice Address - Fax:305-238-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 65476261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation