Healthcare Provider Details

I. General information

NPI: 1548100407
Provider Name (Legal Business Name): MY MOBILITY REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17560 NW 27TH AVE STE 122
MIAMI GARDENS FL
33056-4075
US

IV. Provider business mailing address

17560 NW 27TH AVE STE 122
MIAMI GARDENS FL
33056-4075
US

V. Phone/Fax

Practice location:
  • Phone: 786-399-3689
  • Fax:
Mailing address:
  • Phone: 786-399-3689
  • Fax:

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: MISLEIVY HERNANDEZ CARMONA
Title or Position: OWNER
Credential:
Phone: 786-399-3689