Healthcare Provider Details

I. General information

NPI: 1982930418
Provider Name (Legal Business Name): BIRD ROAD REHAB CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2009
Last Update Date: 10/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7480 BIRD RD STE 660
MIAMI FL
33155-6658
US

IV. Provider business mailing address

7480 BIRD RD STE 660
MIAMI FL
33155-6658
US

V. Phone/Fax

Practice location:
  • Phone: 305-244-6285
  • Fax:
Mailing address:
  • Phone: 305-244-6285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberCH 4496
License Number StateFL

VIII. Authorized Official

Name: TERESA TESTA
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-244-6285