Provider Demographics
NPI:1841577061
Name:COMPLETE REHABILITATION & MASSAGE CENTER INC.
Entity Type:Organization
Organization Name:COMPLETE REHABILITATION & MASSAGE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-370-9833
Mailing Address - Street 1:12060 SW 129 CT ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186
Mailing Address - Country:US
Mailing Address - Phone:786-273-2884
Mailing Address - Fax:
Practice Address - Street 1:12060 SW 129TH CT
Practice Address - Street 2:SUITE 207
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4581
Practice Address - Country:US
Practice Address - Phone:786-273-2884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 56602261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy