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General NPI Number Information
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NPI Number | 1053965210
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Entity Type | Organization
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Legal Business Name | MJY REHABILITATION CENTER,INC
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Dates
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Enumeration Date | 07/26/2019
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 11055 SW 186TH ST STE 302
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City | CUTLER BAY
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State | FL
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Zip | 33157-6843
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Country | US
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Telephone | 786-238-6799
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Fax |
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Provider Business Mailing Address
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Address Line | 11055 SW 186TH ST STE 302
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City | CUTLER BAY
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State | FL
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Zip | 33157-6843
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Country | US
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Telephone | 786-238-6799
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MAGDIEL NIETO
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Credential |
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Telephone | 305-297-3169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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