MEDICARE: BE-WELL MEDICAL REHAB 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	174400000X	Specialist

General Provider Information

NPI Number	:	1457365421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE-WELL MEDICAL REHAB INC.

Provider Business Mailing Address
First Line	:	6363 TAFT ST
Second Line	:	SUITE 1004
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5962
Country	:	US
Telephone Number	:	786-663-1303
Fax Number	:	954-987-1355

Provider Business Practice Location Address
First Line	:	6363 TAFT ST
Second Line	:	SUITE 1004
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5962
Country	:	US
Telephone Number	:	786-663-1303
Fax Number	:	954-987-1355

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IVAN PEREZ MOREIRA
Credential	:
Telephone Number	:	786-663-1303

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	08/22/2020

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