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General NPI Number Information
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NPI Number | 1073991568
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Entity Type | Organization
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Legal Business Name | MIAMI REHAB CENTER, INC
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Dates
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Enumeration Date | 05/15/2015
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 11300 NW 87TH CT SUITE # 157
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4586
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Country | US
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Telephone | 786-762-3915
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Fax | 786-762-3916
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Provider Business Mailing Address
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Address Line | 11300 NW 87TH CT SUITE # 157
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4586
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Country | US
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Telephone | 786-762-3915
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Fax | 786-762-3916
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Authorized Official
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Title or Position | RPT
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Name | MR. LUIS FERNANDO ROA
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Credential |
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Telephone | 786-553-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PT22682
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License Number State | FL
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