Healthcare Provider Details

I. General information

NPI: 1386886570
Provider Name (Legal Business Name): WEST KENDALL PAIN - REHAB MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13205 SW 137TH AVE SUITE 211
MIAMI FL
33186-5331
US

IV. Provider business mailing address

13205 SW 137TH AVE SUITE 211
MIAMI FL
33186-5331
US

V. Phone/Fax

Practice location:
  • Phone: 305-401-3965
  • Fax: 305-274-0692
Mailing address:
  • Phone: 305-401-3965
  • Fax: 305-274-0692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SUAREZ
Title or Position: PRESIDENT / OWNER
Credential: MD
Phone: 305-401-3965