Healthcare Provider Details
I. General information
NPI: 1467802801
Provider Name (Legal Business Name): ACCIDENT REHAB DBA AMERICAN MEDICAL & REHAB CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2016
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27315 S DIXIE HWY
NARANJA FL
33032-8232
US
IV. Provider business mailing address
27315 S DIXIE HWY
NARANJA FL
33032-8232
US
V. Phone/Fax
- Phone: 305-245-3333
- Fax: 305-245-3340
- Phone: 305-245-3333
- Fax: 305-245-3340
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MARIA
P.
VASQUEZ
Title or Position: VICE PRESIDENT
Credential:
Phone: 305-305-7565