Healthcare Provider Details

I. General information

NPI: 1689860280
Provider Name (Legal Business Name): MIAMI NEUROLOGY & REHABILITATION SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 SUNSET DR STE 405
SOUTH MIAMI FL
33143-5198
US

IV. Provider business mailing address

5975 SUNSET DR STE 405
SOUTH MIAMI FL
33143-5198
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-8040
  • Fax: 305-661-8891
Mailing address:
  • Phone: 305-661-8040
  • Fax: 305-661-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN MARTIN
Title or Position: OWNER
Credential: PT
Phone: 305-661-8040