Provider Demographics
NPI:1922385798
Name:M.G. REHABILITATION M.C.,LLC
Entity Type:Organization
Organization Name:M.G. REHABILITATION M.C.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELQUIES
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ ASENJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-860-1120
Mailing Address - Street 1:2700 SW 3RD AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2331
Mailing Address - Country:US
Mailing Address - Phone:305-860-1120
Mailing Address - Fax:305-860-1124
Practice Address - Street 1:2700 SW 3RD AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2331
Practice Address - Country:US
Practice Address - Phone:305-860-1120
Practice Address - Fax:305-860-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center