Healthcare Provider Details

I. General information

NPI: 1891700373
Provider Name (Legal Business Name): SOUTH FLORIDA REHABILITATION CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 SW 104TH ST
MIAMI FL
33156-3556
US

IV. Provider business mailing address

11301 S DIXIE HWY UNIT 565841
MIAMI FL
33256-7244
US

V. Phone/Fax

Practice location:
  • Phone: 786-554-0949
  • Fax: 305-412-9098
Mailing address:
  • Phone: 305-412-9099
  • Fax: 305-412-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. FULVIA V BARRERA
Title or Position: PRESIDENT
Credential: PT
Phone: 305-412-9099