MEDICARE: CAIBASIEN REHABILITATION CENTER, CORP.

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	HCC6561	FL

General Provider Information

NPI Number	:	1962441949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAIBASIEN REHABILITATION CENTER, CORP.

Provider Business Mailing Address
First Line	:	11300 NW 87TH CT
Second Line	:	SUITE 162
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4586
Country	:	US
Telephone Number	:	305-556-2535
Fax Number	:	305-556-2564

Provider Business Practice Location Address
First Line	:	11300 NW 87TH CT
Second Line	:	SUITE 162
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4586
Country	:	US
Telephone Number	:	305-556-2535
Fax Number	:	305-556-2564

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDUARDO ESPINOSA
Credential	:
Telephone Number	:	305-556-2535

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/25/2008

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