Provider Demographics
NPI:1649504671
Name:SYNTRICITY REHAB SOLUTIONS OF KY, LLC.
Entity type:Organization
Organization Name:SYNTRICITY REHAB SOLUTIONS OF KY, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.F,O.
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELVA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-279-1134
Mailing Address - Street 1:1835 NE MIAMI GARDENS DRIVE #167
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-0470
Mailing Address - Country:US
Mailing Address - Phone:786-279-1134
Mailing Address - Fax:305-652-4070
Practice Address - Street 1:1705 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1044
Practice Address - Country:US
Practice Address - Phone:502-451-7330
Practice Address - Fax:305-652-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)