Provider Demographics
NPI:1952404907
Name:REHAB CARE LLC
Entity Type:Organization
Organization Name:REHAB CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-268-7619
Mailing Address - Street 1:4345 SW 72ND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4530
Mailing Address - Country:US
Mailing Address - Phone:786-268-7619
Mailing Address - Fax:786-268-7620
Practice Address - Street 1:4345 SW 72ND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4530
Practice Address - Country:US
Practice Address - Phone:786-268-7619
Practice Address - Fax:786-268-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL686857261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686857Medicare Oscar/Certification