Healthcare Provider Details

I. General information

NPI: 1437158037
Provider Name (Legal Business Name): REHABILITATION OF SOUTH FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2590 SW 107TH AVE
MIAMI FL
33165-2400
US

IV. Provider business mailing address

2590 SW 107TH AVE
MIAMI FL
33165-2400
US

V. Phone/Fax

Practice location:
  • Phone: 305-226-7718
  • Fax: 305-226-7941
Mailing address:
  • Phone: 305-226-7718
  • Fax: 305-226-7941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA18496
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA36707
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT10382
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT19177
License Number StateFL

VIII. Authorized Official

Name: MR. WILLIAM LOPEZ
Title or Position: PRESIDENT
Credential: OTR/L
Phone: 305-226-7718