Provider Demographics
NPI:1255516316
Name:C & M REHABILITATION CENTER INC
Entity type:Organization
Organization Name:C & M REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERNANDEZ-POMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-817-3585
Mailing Address - Street 1:3750 W 16TH AVE
Mailing Address - Street 2:#110
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4654
Mailing Address - Country:US
Mailing Address - Phone:305-817-3585
Mailing Address - Fax:305-817-3588
Practice Address - Street 1:3750 W 16TH AVE
Practice Address - Street 2:#110
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4654
Practice Address - Country:US
Practice Address - Phone:305-817-3585
Practice Address - Fax:305-817-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty