Provider Demographics
NPI:1891837548
Name:DADE INJURY REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:DADE INJURY REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-623-5939
Mailing Address - Street 1:17325 NW 27TH AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33056-4056
Mailing Address - Country:US
Mailing Address - Phone:305-623-5939
Mailing Address - Fax:
Practice Address - Street 1:17325 NW 27TH AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33056-4056
Practice Address - Country:US
Practice Address - Phone:305-623-5939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty