Provider Demographics
NPI:1851636997
Name:A&A PROFESSIONAL REHABILITATION CENTER CORP
Entity Type:Organization
Organization Name:A&A PROFESSIONAL REHABILITATION CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:CELSO
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:RAVELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-803-3282
Mailing Address - Street 1:3900 NW 79TH AVE
Mailing Address - Street 2:SUITE 589
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6556
Mailing Address - Country:US
Mailing Address - Phone:908-803-3282
Mailing Address - Fax:
Practice Address - Street 1:3900 NW 79TH AVE
Practice Address - Street 2:SUITE 589
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6556
Practice Address - Country:US
Practice Address - Phone:908-803-3282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management