Provider Demographics
NPI:1790056224
Name:PAIN CARE REHABILITATION SERVICES
Entity Type:Organization
Organization Name:PAIN CARE REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YUNAYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:786-444-9296
Mailing Address - Street 1:1400 W 41ST ST APT B
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5921
Mailing Address - Country:US
Mailing Address - Phone:786-444-9296
Mailing Address - Fax:
Practice Address - Street 1:1400 W 41ST ST APT B
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5921
Practice Address - Country:US
Practice Address - Phone:786-444-9296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy