Provider Demographics
NPI:1881074466
Name:A-1 ADVANCE REHAB CENTER INC
Entity type:Organization
Organization Name:A-1 ADVANCE REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-615-9386
Mailing Address - Street 1:3801 SW 117TH AVE
Mailing Address - Street 2:NUMBER 654424
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33265-6901
Mailing Address - Country:US
Mailing Address - Phone:305-615-9386
Mailing Address - Fax:305-541-8091
Practice Address - Street 1:3801 SW 117TH AVE
Practice Address - Street 2:NUMBER 654424
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33265-6901
Practice Address - Country:US
Practice Address - Phone:305-615-9386
Practice Address - Fax:305-541-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service