MEDICARE: QUALITY REHAB TRANSPORTATION,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1326327065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY REHAB TRANSPORTATION,INC.

Provider Business Mailing Address
First Line	:	4115 SW 97TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5114
Country	:	US
Telephone Number	:	786-326-0917
Fax Number	:	786-431-2447

Provider Business Practice Location Address
First Line	:	4115 SW 97TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5114
Country	:	US
Telephone Number	:	786-326-0917
Fax Number	:	786-431-2447

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CARLOS ENRIQUE RUIZ
Credential	:
Telephone Number	:	786-389-2248

Provider Enumeration Date	:	08/11/2011
Last Update Date	:	08/11/2011

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