Provider Demographics
NPI:1295073229
Name:REHABILITATION HERALD CENTER CORP
Entity type:Organization
Organization Name:REHABILITATION HERALD CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILENKO
Authorized Official - Middle Name:S
Authorized Official - Last Name:REDONDO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-547-7139
Mailing Address - Street 1:8150 SW 8TH ST
Mailing Address - Street 2:SUITE H204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4263
Mailing Address - Country:US
Mailing Address - Phone:786-547-7139
Mailing Address - Fax:
Practice Address - Street 1:8150 SW 8TH ST
Practice Address - Street 2:SUITE H204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4263
Practice Address - Country:US
Practice Address - Phone:786-547-7139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA63233261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation