Provider Demographics
NPI:1932120045
Name:P & M REHABILITATION SERVICES CORP
Entity Type:Organization
Organization Name:P & M REHABILITATION SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ CALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-313-0111
Mailing Address - Street 1:1255 W 46TH ST
Mailing Address - Street 2:SUITE 25
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3283
Mailing Address - Country:US
Mailing Address - Phone:786-313-0111
Mailing Address - Fax:786-313-0075
Practice Address - Street 1:1255 W 46TH ST
Practice Address - Street 2:SUITE 25
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3283
Practice Address - Country:US
Practice Address - Phone:786-313-0111
Practice Address - Fax:786-313-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL523598-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686800Medicare ID - Type Unspecified