Provider Demographics
NPI:1558014472
Name:LUCKY MEDICAL & REHABILITATION CENTER CORP
Entity Type:Organization
Organization Name:LUCKY MEDICAL & REHABILITATION CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:KARLA
Authorized Official - Last Name:PERERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-953-4685
Mailing Address - Street 1:6001 W FLAGLER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3212
Mailing Address - Country:US
Mailing Address - Phone:786-953-4685
Mailing Address - Fax:786-953-4934
Practice Address - Street 1:6001 W FLAGLER ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3212
Practice Address - Country:US
Practice Address - Phone:786-953-4685
Practice Address - Fax:786-953-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy