Provider Demographics
NPI:1568819746
Name:MEDICAL AND REHABILITATION CENTER,INC
Entity Type:Organization
Organization Name:MEDICAL AND REHABILITATION CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-502-4500
Mailing Address - Street 1:2711 SW 137TH AVE
Mailing Address - Street 2:SUITE 83
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6359
Mailing Address - Country:US
Mailing Address - Phone:786-502-4500
Mailing Address - Fax:786-502-4505
Practice Address - Street 1:2711 SW 137TH AVE
Practice Address - Street 2:SUITE 83
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6359
Practice Address - Country:US
Practice Address - Phone:786-502-4500
Practice Address - Fax:786-502-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty