Provider Demographics
NPI:1639833403
Name:STAR REHABILITATION SERVICE CENTER INC
Entity Type:Organization
Organization Name:STAR REHABILITATION SERVICE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAMAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-562-6785
Mailing Address - Street 1:2721 SW 137TH AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6319
Mailing Address - Country:US
Mailing Address - Phone:786-562-6785
Mailing Address - Fax:
Practice Address - Street 1:2721 SW 137TH AVE STE 118
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6319
Practice Address - Country:US
Practice Address - Phone:786-562-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty