Provider Demographics
NPI:1669640157
Name:ALL STAR REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:ALL STAR REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-826-1831
Mailing Address - Street 1:5881 NW 151ST ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2450
Mailing Address - Country:US
Mailing Address - Phone:305-826-1831
Mailing Address - Fax:305-826-1844
Practice Address - Street 1:5881 NW 151ST ST
Practice Address - Street 2:SUITE 120
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2450
Practice Address - Country:US
Practice Address - Phone:305-826-1831
Practice Address - Fax:305-826-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2008-3274261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy