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General NPI Number Information
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NPI Number | 1083815286
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Entity Type | Organization
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Legal Business Name | AVENTURA WELLNESS AND REHAB CENTER, INC.
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 2440 NE MIAMI GARDENS DR SUITE 101
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City | AVENTURA
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State | FL
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Zip | 33180-2734
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Country | US
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Telephone | 305-705-0777
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Fax | 305-705-9978
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Provider Business Mailing Address
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Address Line | 2440 NE MIAMI GARDENS DR SUITE 101
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City | AVENTURA
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State | FL
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Zip | 33180-2734
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Country | US
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Telephone | 305-705-0777
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Fax | 305-705-9978
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | BERNARD A. GREAUX
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Credential | D.C.
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Telephone | 305-705-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 501515-1
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License Number State | FL
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