Healthcare Provider Details

I. General information

NPI: 1518592799
Provider Name (Legal Business Name): SERVICEMEN REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2020
Last Update Date: 03/07/2020
Certification Date: 03/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 SW 8TH ST STE 23B
MIAMI FL
33174-2969
US

IV. Provider business mailing address

10711 SW 46TH ST
MIAMI FL
33165-4838
US

V. Phone/Fax

Practice location:
  • Phone: 305-228-9626
  • Fax: 305-228-9628
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADNER DIAZ VALLES
Title or Position: PRESIDENT
Credential:
Phone: 305-228-9626