Healthcare Provider Details
I. General information
NPI: 1073785291
Provider Name (Legal Business Name): AMEDICARE REHAB CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11117 W OKEECHOBEE RD STE 209
HIALEAH FL
33018-4211
US
IV. Provider business mailing address
5891 W 9TH LN
HIALEAH FL
33012-2358
US
V. Phone/Fax
- Phone: 786-357-8111
- Fax:
- Phone: 786-357-8111
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QE0002X |
| Taxonomy | Emergency Care Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP3300X |
| Taxonomy | Pain Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LILIANA
M
HADFEG
Title or Position: PRESIDENT
Credential:
Phone: 786-357-8111