Healthcare Provider Details

I. General information

NPI: 1114515319
Provider Name (Legal Business Name): ADVANCED RECOVERY REHAB CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST STE 190
MIAMI FL
33173-3040
US

IV. Provider business mailing address

10300 SW 72ND ST STE 190
MIAMI FL
33173-3040
US

V. Phone/Fax

Practice location:
  • Phone: 305-639-8292
  • Fax:
Mailing address:
  • Phone: 305-639-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALVARO ALEJANDRO AGUERO
Title or Position: PT
Credential:
Phone: 305-639-8292