Provider Demographics
NPI:1710289251
Name:AMERICAN REHABILITATION CORP
Entity Type:Organization
Organization Name:AMERICAN REHABILITATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:305-263-7926
Mailing Address - Street 1:85 GRAND CANAL DR
Mailing Address - Street 2:SUITE 405
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2561
Mailing Address - Country:US
Mailing Address - Phone:305-263-7926
Mailing Address - Fax:305-263-7920
Practice Address - Street 1:85 GRAND CANAL DR
Practice Address - Street 2:SUITE 405
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2561
Practice Address - Country:US
Practice Address - Phone:305-263-7926
Practice Address - Fax:305-263-7920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 42951261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation