Provider Demographics
NPI:1558723692
Name:CULUMBIA REHAB MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:CULUMBIA REHAB MEDICAL CENTER CORP
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBAINA
Authorized Official - Suffix:I
Authorized Official - Credentials:OWNER
Authorized Official - Phone:305-558-9344
Mailing Address - Street 1:126 E 49TH ST
Mailing Address - Street 2:126
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1853
Mailing Address - Country:US
Mailing Address - Phone:305-558-9344
Mailing Address - Fax:305-558-9341
Practice Address - Street 1:126 E 49TH ST
Practice Address - Street 2:126
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1853
Practice Address - Country:US
Practice Address - Phone:305-558-9344
Practice Address - Fax:305-558-9341
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CULUMBIA REHAB MEDICAL CENTER CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN/AOtherREHABILITATION CENTER
FLN/AOtherREHABILITATION CENTER