Provider Demographics
NPI:1295976116
Name:JCR REHABILITATION SERVICES OF KENDALL INC
Entity type:Organization
Organization Name:JCR REHABILITATION SERVICES OF KENDALL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMER
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGING DIRECTOR
Authorized Official - Phone:786-619-2293
Mailing Address - Street 1:15190 S,W, 136 STREET
Mailing Address - Street 2:SUITE 2-3
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196
Mailing Address - Country:US
Mailing Address - Phone:786-619-2293
Mailing Address - Fax:786-619-2297
Practice Address - Street 1:15190 SW 136TH ST
Practice Address - Street 2:SUITE 2-3
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2604
Practice Address - Country:US
Practice Address - Phone:786-619-2293
Practice Address - Fax:786-619-2297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy