MEDICARE: J.R.C REHABILITATION MEDICAL CENTER, 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	261QM1300X	Multi-Specialty Clinic/Center	HCC6661	FL

General Provider Information

NPI Number	:	1679526677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J.R.C REHABILITATION MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	555 E 25TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3848
Country	:	US
Telephone Number	:	305-836-2474
Fax Number	:	305-836-2475

Provider Business Practice Location Address
First Line	:	555 E 25TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3848
Country	:	US
Telephone Number	:	305-836-2474
Fax Number	:	305-836-2475

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ROBERTA ASCENCION
Credential	:
Telephone Number	:	305-836-2474

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	08/22/2020

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