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General NPI Number Information
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NPI Number | 1114451408
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Entity Type | Organization
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Legal Business Name | WELLNESS REHAB OF SOUTH FLORIDA INC.
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 1600 S FEDERAL HWY STE 550
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7518
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Country | US
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Telephone | 561-866-7794
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Fax | 954-657-8358
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Provider Business Mailing Address
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Address Line | 1600 S FEDERAL HWY STE 550
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7518
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Country | US
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Telephone | 561-866-7794
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Fax | 954-657-8358
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Authorized Official
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Title or Position | CEO
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Name | JAIRILENA M VIANA
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Credential |
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Telephone | 561-866-7794
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | P17000009153
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License Number State | FL
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