Provider Demographics
NPI:1861472383
Name:JOE REHABILITATION & DIAGNOSTIC INC
Entity Type:Organization
Organization Name:JOE REHABILITATION & DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NORKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-718-8626
Mailing Address - Street 1:1470 NW 107TH AVE
Mailing Address - Street 2:STE S
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2744
Mailing Address - Country:US
Mailing Address - Phone:305-718-8626
Mailing Address - Fax:305-718-8621
Practice Address - Street 1:1470 NW 107TH AVE
Practice Address - Street 2:STE S
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2744
Practice Address - Country:US
Practice Address - Phone:305-718-8626
Practice Address - Fax:305-718-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686641Medicare Oscar/Certification