Healthcare Provider Details

I. General information

NPI: 1275294241
Provider Name (Legal Business Name): AMERICAN GROUP REHABILITATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10240 SW 56TH ST STE 105
MIAMI FL
33165-7066
US

IV. Provider business mailing address

10305 NW 41ST ST STE 107
DORAL FL
33178-2975
US

V. Phone/Fax

Practice location:
  • Phone: 305-418-2385
  • Fax: 305-418-1888
Mailing address:
  • Phone: 305-418-2385
  • Fax: 305-418-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: YUSNIEL MARIN
Title or Position: PRESIDENT
Credential: LMT
Phone: 305-418-2385