Provider Demographics
NPI:1821049685
Name:UNIVERSAL REHAB MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:UNIVERSAL REHAB MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-644-7980
Mailing Address - Street 1:3383 NW 7TH ST
Mailing Address - Street 2:#307
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4140
Mailing Address - Country:US
Mailing Address - Phone:305-644-7980
Mailing Address - Fax:305-644-7982
Practice Address - Street 1:3383 NW 7TH ST
Practice Address - Street 2:#307
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4140
Practice Address - Country:US
Practice Address - Phone:305-644-7980
Practice Address - Fax:305-644-7982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6783208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9702Medicare ID - Type Unspecified