Provider Demographics
NPI:1548587249
Name:ORG REHABILITATION CENTER,INC
Entity Type:Organization
Organization Name:ORG REHABILITATION CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:OMAYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA44609
Authorized Official - Phone:305-392-0175
Mailing Address - Street 1:2100 W 76 ST
Mailing Address - Street 2:STE 312
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-392-0175
Mailing Address - Fax:305-392-0175
Practice Address - Street 1:2100 W 76TH ST
Practice Address - Street 2:STE 312
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5539
Practice Address - Country:US
Practice Address - Phone:305-392-0175
Practice Address - Fax:305-392-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy