Provider Demographics
NPI:1336530419
Name:PRATZ REHABILITATION CENTER
Entity Type:Organization
Organization Name:PRATZ REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:RINCON LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-402-4282
Mailing Address - Street 1:244 5TH AVE
Mailing Address - Street 2:SUITE 2631
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7604
Mailing Address - Country:US
Mailing Address - Phone:917-402-4282
Mailing Address - Fax:646-219-2701
Practice Address - Street 1:1421 SW 107TH AVE
Practice Address - Street 2:# 128
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2526
Practice Address - Country:US
Practice Address - Phone:917-402-4282
Practice Address - Fax:646-219-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service