Provider Demographics
NPI:1891078853
Name:M & J REHAB SERVICE INC.
Entity Type:Organization
Organization Name:M & J REHAB SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C E O
Authorized Official - Prefix:
Authorized Official - First Name:NOELIO
Authorized Official - Middle Name:H
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-299-5329
Mailing Address - Street 1:930 NW 123RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2411
Mailing Address - Country:US
Mailing Address - Phone:786-299-5329
Mailing Address - Fax:
Practice Address - Street 1:930 NW 123RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-2411
Practice Address - Country:US
Practice Address - Phone:786-299-5329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA62218261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy