Provider Demographics
NPI:1952352262
Name:NATIONAL REHABILITATION OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:NATIONAL REHABILITATION OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-556-6817
Mailing Address - Street 1:2800 W 84TH ST
Mailing Address - Street 2:STE 12
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4922
Mailing Address - Country:US
Mailing Address - Phone:305-556-6817
Mailing Address - Fax:305-556-6810
Practice Address - Street 1:2800 W 84TH ST
Practice Address - Street 2:STE 12
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4922
Practice Address - Country:US
Practice Address - Phone:305-556-6817
Practice Address - Fax:305-556-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
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
684559Medicare Oscar/Certification