Provider Demographics
NPI:1487181400
Name:TAMIAMI REHAB CENTER CORP
Entity Type:Organization
Organization Name:TAMIAMI REHAB CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BAYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:MALGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-484-9205
Mailing Address - Street 1:10887 NW 17TH ST UNIT 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2044
Mailing Address - Country:US
Mailing Address - Phone:786-359-4999
Mailing Address - Fax:786-359-4843
Practice Address - Street 1:10887 NW 17TH ST UNIT 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-2044
Practice Address - Country:US
Practice Address - Phone:786-359-4999
Practice Address - Fax:786-359-4843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208100000X
FLHCC11031208D00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty