Provider Demographics
NPI:1952644551
Name:EXCELLENCE WELLNESS REHAB CENTER, INC
Entity Type:Organization
Organization Name:EXCELLENCE WELLNESS REHAB CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-452-8071
Mailing Address - Street 1:5200 SW 8TH ST STE 201B
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2337
Mailing Address - Country:US
Mailing Address - Phone:786-452-8071
Mailing Address - Fax:786-452-8093
Practice Address - Street 1:5200 SW 8TH ST STE 201B
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2337
Practice Address - Country:US
Practice Address - Phone:786-452-8071
Practice Address - Fax:786-452-8093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9581261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty