Healthcare Provider Details

I. General information

NPI: 1053852186
Provider Name (Legal Business Name): B & C REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SW 27TH AVE SUITE 403
MIAMI FL
33145-2457
US

IV. Provider business mailing address

1800 SW 27TH AVE SUITE 403
MIAMI FL
33145-2457
US

V. Phone/Fax

Practice location:
  • Phone: 305-603-9388
  • Fax:
Mailing address:
  • Phone: 305-603-9388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberME111279
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME111279
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME111279
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License NumberME111279
License Number StateFL

VIII. Authorized Official

Name: FREDERICK BAPTISTA
Title or Position: PRESIDENT
Credential:
Phone: 305-603-9388