Provider Demographics
NPI:1861677767
Name:CITY CORF INC
Entity Type:Organization
Organization Name:CITY CORF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:RULKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-651-1319
Mailing Address - Street 1:4032 N POWERLINE RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5053
Mailing Address - Country:US
Mailing Address - Phone:954-564-1140
Mailing Address - Fax:954-564-1188
Practice Address - Street 1:4032 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5053
Practice Address - Country:US
Practice Address - Phone:954-564-1140
Practice Address - Fax:954-564-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686765Medicare Oscar/Certification