Healthcare Provider Details

I. General information

NPI: 1487847158
Provider Name (Legal Business Name): E & M REHAB & MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1893 NE 164TH ST # 100
NORTH MIAMI BEACH FL
33162-4168
US

IV. Provider business mailing address

1893 NE 164TH ST # 100
NORTH MIAMI BEACH FL
33162-4168
US

V. Phone/Fax

Practice location:
  • Phone: 786-274-8010
  • Fax: 786-274-8020
Mailing address:
  • Phone: 786-274-8010
  • Fax: 786-274-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberHCC5174
License Number StateFL

VIII. Authorized Official

Name: MR. EDNER ROUZARD
Title or Position: PRESIDENT
Credential:
Phone: 786-274-8010