Healthcare Provider Details

I. General information

NPI: 1730168675
Provider Name (Legal Business Name): ELITE REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W 49TH ST STE 216
HIALEAH FL
33012-3402
US

IV. Provider business mailing address

900 W 49TH ST STE 216
HIALEAH FL
33012-3402
US

V. Phone/Fax

Practice location:
  • Phone: 305-836-4346
  • Fax: 305-836-5904
Mailing address:
  • Phone: 305-836-4346
  • Fax: 305-836-5904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SONIA ANGUEIRA
Title or Position: PRESIDENT
Credential:
Phone: 305-836-4345