Provider Demographics
NPI:1295754331
Name:UNITED REHABILITATION INC
Entity type:Organization
Organization Name:UNITED REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-763-5718
Mailing Address - Street 1:4343 W FLAGLER ST
Mailing Address - Street 2:STE 503
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1586
Mailing Address - Country:US
Mailing Address - Phone:305-763-5718
Mailing Address - Fax:305-567-0615
Practice Address - Street 1:4343 W FLAGLER ST
Practice Address - Street 2:STE 503
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1586
Practice Address - Country:US
Practice Address - Phone:305-763-5718
Practice Address - Fax:305-567-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL686680261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686680Medicare Oscar/Certification