Healthcare Provider Details

I. General information

NPI: 1265731640
Provider Name (Legal Business Name): FLORIDA REHAB PROFESSIONALS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
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 Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 3155
License Number StateFL

VIII. Authorized Official

Name: LYNDA HEREDIA
Title or Position: PRESIDENT
Credential:
Phone: 305-446-1098