Provider Demographics
NPI:1679930796
Name:RESCUE REHAB MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:RESCUE REHAB MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISSETT
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRELONGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMA
Authorized Official - Phone:786-615-4346
Mailing Address - Street 1:85 GRAND CANAL DR
Mailing Address - Street 2:SUITE 408
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2561
Mailing Address - Country:US
Mailing Address - Phone:786-615-4346
Mailing Address - Fax:786-615-4548
Practice Address - Street 1:85 GRAND CANAL DR
Practice Address - Street 2:SUITE 408
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2561
Practice Address - Country:US
Practice Address - Phone:786-615-4346
Practice Address - Fax:786-615-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208100000X, 208D00000X
FLME28516261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty