Provider Demographics
NPI:1518271501
Name:AJS REHAB CENTER INC
Entity Type:Organization
Organization Name:AJS REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-287-9451
Mailing Address - Street 1:4343 W FLAGLER ST
Mailing Address - Street 2:406
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1586
Mailing Address - Country:US
Mailing Address - Phone:786-287-9451
Mailing Address - Fax:786-360-3615
Practice Address - Street 1:4343 W FLAGLER ST
Practice Address - Street 2:406
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1586
Practice Address - Country:US
Practice Address - Phone:786-287-9451
Practice Address - Fax:786-360-3615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8363261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFILE 8542OtherAHCA EXEMPT HCC UNIT