Provider Demographics
NPI:1750320156
Name:REHABILITATION CENTER OF MIAMI LLC
Entity Type:Organization
Organization Name:REHABILITATION CENTER OF MIAMI LLC
Other - Org Name:REHABILITATION CENTER OF MIAMI
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WIKLUND SABA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:305-856-9000
Mailing Address - Street 1:420 S DIXIE HWY STE 4D
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2232
Mailing Address - Country:US
Mailing Address - Phone:305-856-9000
Mailing Address - Fax:305-856-9910
Practice Address - Street 1:420 S DIXIE HWY STE 4D
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2232
Practice Address - Country:US
Practice Address - Phone:305-856-9000
Practice Address - Fax:305-856-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15261261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888136700Medicaid
FL6400287OtherMEDICARE COMPLETE
FLY9475ZMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
FLK4216Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER