Provider Demographics
NPI:1831128057
Name:JPL REHABILITATION, INC.
Entity Type:Organization
Organization Name:JPL REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MADELAINE
Authorized Official - Middle Name:AMPARO
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-644-6160
Mailing Address - Street 1:348 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3031
Mailing Address - Country:US
Mailing Address - Phone:305-644-6160
Mailing Address - Fax:305-644-6161
Practice Address - Street 1:348 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3031
Practice Address - Country:US
Practice Address - Phone:305-644-6160
Practice Address - Fax:305-644-6161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC3953OtherHCCL LICENSE