Provider Demographics
NPI:1710906839
Name:ANGELIC REHAB CENTER INC
Entity Type:Organization
Organization Name:ANGELIC REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-635-3485
Mailing Address - Street 1:8300 W FLAGLER ST
Mailing Address - Street 2:STE 150
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-6000
Mailing Address - Country:US
Mailing Address - Phone:305-635-3485
Mailing Address - Fax:305-220-4796
Practice Address - Street 1:8300 W FLAGLER ST
Practice Address - Street 2:STE 150
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-6000
Practice Address - Country:US
Practice Address - Phone:305-635-3485
Practice Address - Fax:305-220-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686871Medicare PIN