Provider Demographics
NPI:1932293420
Name:FENIX PHYSICAL REHAB CENTER, INC.
Entity Type:Organization
Organization Name:FENIX PHYSICAL REHAB CENTER, INC.
Other - Org Name:FENIX PHYSICAL REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER/CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:LAYLLE-HYMEL
Authorized Official - Suffix:IV
Authorized Official - Credentials:LMT
Authorized Official - Phone:305-642-9099
Mailing Address - Street 1:3899 NW 7 STREET
Mailing Address - Street 2:OFFICE 200-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:305-642-9099
Mailing Address - Fax:305-642-9717
Practice Address - Street 1:3899 NW 7 STREET
Practice Address - Street 2:OFFICE 200-B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:305-642-9099
Practice Address - Fax:305-642-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty