Healthcare Provider Details

I. General information

NPI: 1629099734
Provider Name (Legal Business Name): SYSTEMS & STRUCTURE REHAB CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 NW 157TH ST STE 111-119
MIAMI LAKES FL
33014-6435
US

IV. Provider business mailing address

4715 NW 157TH ST STE 111-119
MIAMI LAKES FL
33014-6435
US

V. Phone/Fax

Practice location:
  • Phone: 305-342-2481
  • Fax: 800-603-8864
Mailing address:
  • Phone: 305-342-2481
  • Fax: 800-603-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number60081007
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number585246-3
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALIETTE NEYRA
Title or Position: VICE PRESIDENT
Credential:
Phone: 305-342-2481