Provider Demographics
NPI:1922319763
Name:HEALING ELEMENTS REHAB CORP
Entity Type:Organization
Organization Name:HEALING ELEMENTS REHAB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMARILYS
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-325-2096
Mailing Address - Street 1:18245 NW 68TH AVE APT 611
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3479
Mailing Address - Country:US
Mailing Address - Phone:786-325-2096
Mailing Address - Fax:305-827-7087
Practice Address - Street 1:18245 NW 68TH AVE APT 611
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3479
Practice Address - Country:US
Practice Address - Phone:786-325-2096
Practice Address - Fax:305-827-7087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 21752225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty