Healthcare Provider Details

I. General information

NPI: 1003893256
Provider Name (Legal Business Name): JCR REHABILITATION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SW 57TH AVE SUITE 109
MIAMI FL
33155-2164
US

IV. Provider business mailing address

1890 SW 57TH AVE SUITE 109
MIAMI FL
33155-2164
US

V. Phone/Fax

Practice location:
  • Phone: 786-388-9214
  • Fax: 786-388-9195
Mailing address:
  • Phone: 786-388-9214
  • Fax: 786-388-9195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number686791
License Number StateFL

VIII. Authorized Official

Name: JUAN ALEJANDRO PEREZ
Title or Position: OWNER
Credential:
Phone: 786-234-8760