Healthcare Provider Details

I. General information

NPI: 1740755800
Provider Name (Legal Business Name): COMPLEX REHAB SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 NW 122ND ST STE 18
MEDLEY FL
33178-3186
US

IV. Provider business mailing address

10601 NW 122ND ST STE 18
MEDLEY FL
33178-3186
US

V. Phone/Fax

Practice location:
  • Phone: 305-967-8098
  • Fax: 305-437-8027
Mailing address:
  • Phone: 305-967-8098
  • Fax: 305-437-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: NOEL BURNS
Title or Position: MANAGER
Credential:
Phone: 305-321-6680