Healthcare Provider Details
I. General information
NPI: 1891183356
Provider Name (Legal Business Name): JNJ MEDICAL REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2015
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
943 SW 122ND AVE
MIAMI FL
33184-2406
US
IV. Provider business mailing address
943 SW 122ND AVE
MIAMI FL
33184-2406
US
V. Phone/Fax
- Phone: 786-360-6151
- Fax: 786-360-6154
- Phone: 786-360-6151
- Fax: 786-360-6154
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBIEL
RODRIGUEZ
Title or Position: OWNER
Credential:
Phone: 786-360-6151