Provider Demographics
NPI:1649291824
Name:CAPITAL REHAB CENTER, INC
Entity type:Organization
Organization Name:CAPITAL REHAB CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIEZER
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGUILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-266-7778
Mailing Address - Street 1:287 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8010
Mailing Address - Country:US
Mailing Address - Phone:305-266-7778
Mailing Address - Fax:305-266-0933
Practice Address - Street 1:287 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8010
Practice Address - Country:US
Practice Address - Phone:305-266-7778
Practice Address - Fax:305-266-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL479118-3261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684597Medicare ID - Type Unspecified