Provider Demographics
NPI:1558640722
Name:CHOICE MEDICAL REHAB LLC
Entity Type:Organization
Organization Name:CHOICE MEDICAL REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-431-5513
Mailing Address - Street 1:2140 W FLAGLER ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-5600
Mailing Address - Country:US
Mailing Address - Phone:786-431-5513
Mailing Address - Fax:305-646-1319
Practice Address - Street 1:2140 W FLAGLER ST
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-5600
Practice Address - Country:US
Practice Address - Phone:786-431-5513
Practice Address - Fax:305-646-1319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 9188261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC 9188OtherFLORIDA HEALTH CARE