Provider Demographics
NPI:1841483682
Name:NORTH DADE REHABILITATION CENTER LLC
Entity type:Organization
Organization Name:NORTH DADE REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GALLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-945-7246
Mailing Address - Street 1:164 NE 167TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3403
Mailing Address - Country:US
Mailing Address - Phone:305-945-7246
Mailing Address - Fax:305-945-7240
Practice Address - Street 1:164 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3403
Practice Address - Country:US
Practice Address - Phone:305-945-7246
Practice Address - Fax:305-945-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7540111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty