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General NPI Number Information
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NPI Number | 1003975988
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Entity Type | Organization
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Legal Business Name | ASSOCIATES REHAB SOUTH LLC
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5190 NW 167TH ST SUITE 302
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 305-621-2116
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Fax |
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Provider Business Mailing Address
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Address Line | 5190 NW 167TH ST SUITE 302
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 305-621-2116
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | OTTO J VALDES
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Credential |
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Telephone | 305-621-2116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State | FL
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