Provider Demographics
NPI:1871629907
Name:ROMAN CENTER FOR REHABILITATION INC
Entity Type:Organization
Organization Name:ROMAN CENTER FOR REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:HURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-300-5499
Mailing Address - Street 1:9600 SW 8TH ST STE 23B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2969
Mailing Address - Country:US
Mailing Address - Phone:305-300-5499
Mailing Address - Fax:305-228-9628
Practice Address - Street 1:9600 SW 8TH ST STE 23B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2969
Practice Address - Country:US
Practice Address - Phone:305-300-5499
Practice Address - Fax:305-228-9628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686761Medicare Oscar/Certification