Healthcare Provider Details

I. General information

NPI: 1841483682
Provider Name (Legal Business Name): NORTH DADE REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 NE 167TH ST
NORTH MIAMI BEACH FL
33162-3403
US

IV. Provider business mailing address

164 NE 167TH ST
NORTH MIAMI BEACH FL
33162-3403
US

V. Phone/Fax

Practice location:
  • Phone: 305-945-7246
  • Fax: 305-945-7240
Mailing address:
  • Phone: 305-945-7246
  • Fax: 305-945-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberHCC7540
License Number StateFL

VIII. Authorized Official

Name: MS. GALLINA LIGER
Title or Position: GENERAL MANAGER
Credential: RN
Phone: 305-945-7246