Provider Demographics
NPI:1356949101
Name:BRAIN HEALTH & REHABILITATION CORP
Entity type:Organization
Organization Name:BRAIN HEALTH & REHABILITATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANELYS
Authorized Official - Middle Name:S
Authorized Official - Last Name:NETTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-609-7780
Mailing Address - Street 1:3081 SALZEDO ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6725
Mailing Address - Country:US
Mailing Address - Phone:305-609-7780
Mailing Address - Fax:
Practice Address - Street 1:3081 SALZEDO ST STE 202
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6725
Practice Address - Country:US
Practice Address - Phone:305-609-7780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health