MEDICARE: HALLANDALE REHABILITATION 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	173000000X	Legal Medicine	5969887	FL

General Provider Information

NPI Number	:	1659326171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALLANDALE REHABILITATION INC

Provider Business Mailing Address
First Line	:	6447 MIAMI LAKES DR EAST
Second Line	:	SUITE 223
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014
Country	:	US
Telephone Number	:	305-821-5701
Fax Number	:	305-821-5776

Provider Business Practice Location Address
First Line	:	6447 MIAMI LAKES DR EAST
Second Line	:	SUITE 223
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014
Country	:	US
Telephone Number	:	305-821-5701
Fax Number	:	305-821-5776

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. OLGA PEREZ
Credential	:
Telephone Number	:	305-821-5701

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	08/22/2020

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