Provider Demographics
NPI:1508970260
Name:E & B REHAB CORP
Entity Type:Organization
Organization Name:E & B REHAB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ADIANEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:NODARSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-431-1917
Mailing Address - Street 1:9600 SW 8TH ST
Mailing Address - Street 2:SUITE # 9
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2900
Mailing Address - Country:US
Mailing Address - Phone:786-431-1917
Mailing Address - Fax:
Practice Address - Street 1:9600 SW 8TH ST
Practice Address - Street 2:SUITE # 9
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2900
Practice Address - Country:US
Practice Address - Phone:786-431-1917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686806Medicare ID - Type UnspecifiedREHABILITATION CENTER