Provider Demographics
NPI:1497934780
Name:MARTIN REHABILITATION GROUP INC
Entity Type:Organization
Organization Name:MARTIN REHABILITATION GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:TABARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-552-9505
Mailing Address - Street 1:13238 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1176
Mailing Address - Country:US
Mailing Address - Phone:305-552-9505
Mailing Address - Fax:305-552-9953
Practice Address - Street 1:13238 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1176
Practice Address - Country:US
Practice Address - Phone:305-552-9505
Practice Address - Fax:305-552-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70757208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG50845Medicare UPIN