Provider Demographics
NPI:1184926404
Name:PROGRESSIVE REHAB TREATMENTS CORP
Entity type:Organization
Organization Name:PROGRESSIVE REHAB TREATMENTS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:786-423-2842
Mailing Address - Street 1:4000 S 57TH AVE
Mailing Address - Street 2:SUITE: 202
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4307
Mailing Address - Country:US
Mailing Address - Phone:561-649-7881
Mailing Address - Fax:561-649-7528
Practice Address - Street 1:4000 S 57TH AVE
Practice Address - Street 2:SUITE: 202
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4307
Practice Address - Country:US
Practice Address - Phone:561-649-7881
Practice Address - Fax:561-649-7528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty