Provider Demographics
NPI:1619676681
Name:SR NEURO REHAB LLC
Entity Type:Organization
Organization Name:SR NEURO REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-341-3389
Mailing Address - Street 1:1075 N MILLER RD APT 251
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4616
Mailing Address - Country:US
Mailing Address - Phone:602-341-3389
Mailing Address - Fax:480-281-5220
Practice Address - Street 1:1075 N MILLER RD APT 251
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4616
Practice Address - Country:US
Practice Address - Phone:602-341-3389
Practice Address - Fax:480-281-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health