Provider Demographics
NPI:1013267798
Name:86 MEDICAL & REHAB CENTER INC
Entity Type:Organization
Organization Name:86 MEDICAL & REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-332-2721
Mailing Address - Street 1:8660 W. FLAGLER ST. #102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144
Mailing Address - Country:US
Mailing Address - Phone:786-332-2721
Mailing Address - Fax:786-452-0062
Practice Address - Street 1:8660 W. FLAGLER ST. #102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144
Practice Address - Country:US
Practice Address - Phone:786-332-2721
Practice Address - Fax:786-452-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91436261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service