MEDICARE: MIAMI DADE MEDICAL AND REHABILITATION CENTER CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207K00000X	Allergy & Immunology Physician
2	2251G0304X	Geriatric Physical Therapist
3	261QP2000X	Physical Therapy Clinic/Center
4	261QP2300X	Primary Care Clinic/Center
5	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1700543634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI DADE MEDICAL AND REHABILITATION CENTER CORP

Provider Business Mailing Address
First Line	:	760 NW 107TH AVE STE 406
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-3162
Country	:	US
Telephone Number	:	786-334-6928
Fax Number	:	786-828-7919

Provider Business Practice Location Address
First Line	:	760 NW 107TH AVE STE 406
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-3162
Country	:	US
Telephone Number	:	786-334-6928
Fax Number	:	786-828-7919

Authorized Official
Title or Position	:	CFO
Name	:	ERASMO MENENDEZ
Credential	:
Telephone Number	:	786-334-6928

Provider Enumeration Date	:	11/28/2021
Last Update Date	:	10/17/2023

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Directions to “MIAMI DADE MEDICAL AND REHABILITATION CENTER CORP ” Practice Location

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