Provider Demographics
NPI:1891189486
Name:SUNSET DRIVE REHAB CENTER
Entity Type:Organization
Organization Name:SUNSET DRIVE REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-640-0844
Mailing Address - Street 1:10300 SUNSET DR
Mailing Address - Street 2:STE 284
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3012
Mailing Address - Country:US
Mailing Address - Phone:305-640-0844
Mailing Address - Fax:305-640-8845
Practice Address - Street 1:10300 SUNSET DR
Practice Address - Street 2:STE 284
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3012
Practice Address - Country:US
Practice Address - Phone:305-640-0844
Practice Address - Fax:305-640-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service