Provider Demographics
NPI:1740236132
Name:SELECT MEDICAL, INC.
Entity Type:Organization
Organization Name:SELECT MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARISTIDES
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENGUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-220-5142
Mailing Address - Street 1:3955 SW 137TH AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6478
Mailing Address - Country:US
Mailing Address - Phone:305-220-5142
Mailing Address - Fax:305-225-4558
Practice Address - Street 1:3955 SW 137TH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6478
Practice Address - Country:US
Practice Address - Phone:305-220-5142
Practice Address - Fax:305-225-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL998332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1050080001Medicare ID - Type UnspecifiedPROVIDER NUMBER