Healthcare Provider Details

I. General information

NPI: 1841063187
Provider Name (Legal Business Name): LIAN MEDICAL AND REHAB CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7235 CORAL WAY STE 211
MIAMI FL
33155-1452
US

IV. Provider business mailing address

7235 CORAL WAY STE 211
MIAMI FL
33155-1452
US

V. Phone/Fax

Practice location:
  • Phone: 786-838-2685
  • Fax:
Mailing address:
  • Phone: 786-558-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROYNEL MATOS
Title or Position: DIRECTOR
Credential:
Phone: 786-838-2685