Provider Demographics
NPI:1497071088
Name:QUALITY LIFE REHABILITATION CENTER
Entity Type:Organization
Organization Name:QUALITY LIFE REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBIE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:305-819-8755
Mailing Address - Street 1:7760 W 20TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1890
Mailing Address - Country:US
Mailing Address - Phone:305-819-8755
Mailing Address - Fax:305-819-8740
Practice Address - Street 1:7760 W 20TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1890
Practice Address - Country:US
Practice Address - Phone:305-819-8755
Practice Address - Fax:305-819-8740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24504261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center