Provider Demographics
NPI:1942563036
Name:MD HEALTHCARE & REHAB
Entity Type:Organization
Organization Name:MD HEALTHCARE & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADO
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:305-822-2824
Mailing Address - Street 1:7975 NW 154TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5863
Mailing Address - Country:US
Mailing Address - Phone:305-822-2824
Mailing Address - Fax:305-822-2355
Practice Address - Street 1:7975 NW 154TH ST
Practice Address - Street 2:STE 200
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5863
Practice Address - Country:US
Practice Address - Phone:305-822-2824
Practice Address - Fax:305-822-2355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM27455261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC9387OtherAGENCY FOR HEALTH CARE