Provider Demographics
NPI:1912381583
Name:ARTANG REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:ARTANG REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PUPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-280-5686
Mailing Address - Street 1:PO BOX 228806
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33222-8806
Mailing Address - Country:US
Mailing Address - Phone:305-280-5686
Mailing Address - Fax:786-454-2462
Practice Address - Street 1:3100 NW 72ND AVE STE 113
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1335
Practice Address - Country:US
Practice Address - Phone:305-280-5686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty