Provider Demographics
NPI:1912094269
Name:AL USA REHAB CENTER CORP
Entity Type:Organization
Organization Name:AL USA REHAB CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-889-6667
Mailing Address - Street 1:6919 NW 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2835
Mailing Address - Country:US
Mailing Address - Phone:305-889-6667
Mailing Address - Fax:
Practice Address - Street 1:6919 NW 77TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2835
Practice Address - Country:US
Practice Address - Phone:305-889-6667
Practice Address - Fax:305-883-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68-3234Medicare ID - Type UnspecifiedPROVIDER NUMBER