Provider Demographics
NPI:1659386191
Name:INFINITY REHAB CENTER INC.
Entity Type:Organization
Organization Name:INFINITY REHAB CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-306-0778
Mailing Address - Street 1:200 LESLIE DR APT 807
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7317
Mailing Address - Country:US
Mailing Address - Phone:954-304-0447
Mailing Address - Fax:
Practice Address - Street 1:200 LESLIE DR APT 807
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7317
Practice Address - Country:US
Practice Address - Phone:954-304-0447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty