Provider Demographics
NPI:1508208513
Name:APOLLO REHAB
Entity Type:Organization
Organization Name:APOLLO REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:ZEUS
Authorized Official - Middle Name:MEDINA
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:786-877-9416
Mailing Address - Street 1:18840 NW 57TH AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-7027
Mailing Address - Country:US
Mailing Address - Phone:786-877-9416
Mailing Address - Fax:
Practice Address - Street 1:9905 NW 79TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2405
Practice Address - Country:US
Practice Address - Phone:786-877-9416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25873261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy