Provider Demographics
NPI:1912958182
Name:A & J HEALTH CENTER, INC
Entity Type:Organization
Organization Name:A & J HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-825-5155
Mailing Address - Street 1:6080 SW 40TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5233
Mailing Address - Country:US
Mailing Address - Phone:305-825-5155
Mailing Address - Fax:
Practice Address - Street 1:6080 SW 40TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5233
Practice Address - Country:US
Practice Address - Phone:305-825-5155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLK7861273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7861Medicare ID - Type UnspecifiedPROVIDER NUMBER