Provider Demographics
NPI:1881003119
Name:DYNAMIC REHAB HEALTH CENTER CORP
Entity Type:Organization
Organization Name:DYNAMIC REHAB HEALTH CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEJERANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-401-7060
Mailing Address - Street 1:4750 NW 7TH ST
Mailing Address - Street 2:SUITE 13B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2253
Mailing Address - Country:US
Mailing Address - Phone:786-401-7060
Mailing Address - Fax:786-401-7078
Practice Address - Street 1:4750 NW 7TH ST
Practice Address - Street 2:SUITE 13B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2253
Practice Address - Country:US
Practice Address - Phone:786-401-7060
Practice Address - Fax:786-401-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation