Healthcare Provider Details

I. General information

NPI: 1639531577
Provider Name (Legal Business Name): FLORIDA REHAB PROFESSIONALS GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2016
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CORAL WAY STE 403
CORAL GABLES FL
33134-4926
US

IV. Provider business mailing address

401 CORAL WAY STE 403
CORAL GABLES FL
33134-4926
US

V. Phone/Fax

Practice location:
  • Phone: 305-446-1098
  • Fax: 305-446-1638
Mailing address:
  • Phone: 305-446-1098
  • Fax: 305-446-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LYNDA HEREDIA
Title or Position: PRESIDENT/ OWNER
Credential: MS, CCC-SLP
Phone: 305-446-1098