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NPI Code Detail

MEDICARE: EREHAB LLC

MEDICARE: EREHAB LLC
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
1208100000XPhysical Medicine & Rehabilitation PhysicianME114560FL

General Provider Information

NPI Number : 1528461225
Entity Type Code : Organization
Provider Name (Legal Business Name) : EREHAB LLC
Provider Business Mailing Address
First Line : PO BOX 161075
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32716-1075
Country : US
Telephone Number : 787-955-0232
Fax Number :
Provider Business Practice Location Address
First Line : 831 S STATE ROAD 434
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-3502
Country : US
Telephone Number : 787-955-0232
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. ELIAM M FUENTES TIRADO
Credential :
Telephone Number : 787-955-0232
Provider Enumeration Date : 10/08/2014
Last Update Date : 01/21/2022

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Directions to “EREHAB LLC ” Practice Location

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