Healthcare Provider Details

I. General information

NPI: 1962687947
Provider Name (Legal Business Name): ET REHABILITATION CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 SW 8TH ST STE 216
MIAMI FL
33144-4265
US

IV. Provider business mailing address

8150 SW 8TH ST STE 216
MIAMI FL
33144-4265
US

V. Phone/Fax

Practice location:
  • Phone: 786-275-9668
  • Fax:
Mailing address:
  • Phone: 786-275-9668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. ABEL FLEITAS
Title or Position: OWNER
Credential: LMT
Phone: 785-275-9668