Provider Demographics
NPI:1740225390
Name:AMERICAN GROUP REHABILITATION CENTER
Entity Type:Organization
Organization Name:AMERICAN GROUP REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-500-9055
Mailing Address - Street 1:1150 NW 72ND AVE
Mailing Address - Street 2:SUITE 444
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1936
Mailing Address - Country:US
Mailing Address - Phone:305-500-9055
Mailing Address - Fax:
Practice Address - Street 1:1150 NW 72ND AVE
Practice Address - Street 2:SUITE 444
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1936
Practice Address - Country:US
Practice Address - Phone:305-500-9055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL563661-9207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty