Provider Demographics
NPI:1720036478
Name:INTEGRATED REHABILITATION CENTER
Entity Type:Organization
Organization Name:INTEGRATED REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/BCBA
Authorized Official - Phone:305-826-7884
Mailing Address - Street 1:5931 NW 173RD DR
Mailing Address - Street 2:UNIT 10
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5106
Mailing Address - Country:US
Mailing Address - Phone:305-826-7884
Mailing Address - Fax:305-826-1545
Practice Address - Street 1:5931 NW 173RD DR
Practice Address - Street 2:UNIT 10
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33015-5106
Practice Address - Country:US
Practice Address - Phone:305-826-7884
Practice Address - Fax:305-826-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888251700Medicaid
FL019115100Medicaid