Provider Demographics
NPI:1205122702
Name:5 STAR REHABILITATION CENTER, INC
Entity type:Organization
Organization Name:5 STAR REHABILITATION CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYVA ESCALONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-2107
Mailing Address - Street 1:2140 W FLAGLER ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-5600
Mailing Address - Country:US
Mailing Address - Phone:786-360-2107
Mailing Address - Fax:786-360-2168
Practice Address - Street 1:2140 W FLAGLER ST
Practice Address - Street 2:SUITE 212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-5600
Practice Address - Country:US
Practice Address - Phone:786-360-2107
Practice Address - Fax:786-360-2168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7235261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy