Healthcare Provider Details

I. General information

NPI: 1760750269
Provider Name (Legal Business Name): OASIS REHAB AND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8302 NW 103RD ST SUITE 202
HIALEAH GARDENS FL
33016-4697
US

IV. Provider business mailing address

8302 NW 103RD ST SUITE 202
HIALEAH GARDENS FL
33016-4697
US

V. Phone/Fax

Practice location:
  • Phone: 786-487-1786
  • Fax:
Mailing address:
  • Phone: 786-487-1786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUIS R TRUTIE
Title or Position: ADMINISTRATOR
Credential: MT
Phone: 786-487-1786