Healthcare Provider Details

I. General information

NPI: 1184292518
Provider Name (Legal Business Name): REHAB AND RECOVERY LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2021
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7403 MIAMI LAKES DR
MIAMI LAKES FL
33014-6818
US

IV. Provider business mailing address

8294 DUNDEE TER
MIAMI LAKES FL
33016-6418
US

V. Phone/Fax

Practice location:
  • Phone: 305-934-3506
  • Fax:
Mailing address:
  • Phone: 305-934-3506
  • 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: DR. STEFAN VALDES
Title or Position: OWNER
Credential: DPT
Phone: 305-934-3506