Healthcare Provider Details

I. General information

NPI: 1508208513
Provider Name (Legal Business Name): APOLLO REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LAKESIDE DR STE 103
MIRAMAR FL
33027-3261
US

IV. Provider business mailing address

18840 NW 57TH AVE APT 306
HIALEAH FL
33015-7027
US

V. Phone/Fax

Practice location:
  • Phone: 954-342-9333
  • Fax: 954-391-9155
Mailing address:
  • Phone: 786-877-9416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT25873
License Number StateFL

VIII. Authorized Official

Name: ZEUS MEDINA VERA
Title or Position: DOCTOR OF PHYSICAL THERAPY
Credential: DPT
Phone: 786-877-9416