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General NPI Number Information
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NPI Number | 1114254778
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Entity Type | Organization
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Legal Business Name | G & O REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 03/22/2012
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Provider Practice Location Address
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Address Line | 3900 NW 79 AVENUE SUITE 450
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City | DORAL
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State | FL
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Zip | 33166
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Country | US
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Telephone | 305-470-4520
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Fax | 305-470-4521
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Provider Business Mailing Address
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Address Line | 3900 NW 79 AVENUE SUITE 450
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City | DORAL
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State | FL
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Zip | 33166
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Country | US
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Telephone | 305-470-4520
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Fax | 305-470-4521
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUREK MARTINEZ
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Credential |
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Telephone | 305-470-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MA60762
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License Number State | FL
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