Provider Demographics
NPI:1831488121
Name:FLORIDA REHAB PROFESSIONALS GROUP, INC.
Entity type:Organization
Organization Name:FLORIDA REHAB PROFESSIONALS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREDIA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC SLP
Authorized Official - Phone:305-446-1098
Mailing Address - Street 1:401 MIRACLE MILE STE 403
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4926
Mailing Address - Country:US
Mailing Address - Phone:305-446-1098
Mailing Address - Fax:305-446-1638
Practice Address - Street 1:401 MIRACLE MILE STE 403
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4926
Practice Address - Country:US
Practice Address - Phone:305-446-1098
Practice Address - Fax:305-446-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty