Provider Demographics
NPI:1265151013
Name:PHYSICAL REHAB TRAINING LLC
Entity type:Organization
Organization Name:PHYSICAL REHAB TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:N
Authorized Official - Last Name:LUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CPT, SFS
Authorized Official - Phone:305-508-8397
Mailing Address - Street 1:33 E CAMINO REAL APT 119
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6150
Mailing Address - Country:US
Mailing Address - Phone:305-508-8397
Mailing Address - Fax:
Practice Address - Street 1:33 E CAMINO REAL APT 119
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6150
Practice Address - Country:US
Practice Address - Phone:305-508-8397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy