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General NPI Number Information
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NPI Number | 1154788396
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN REHAB CENTER
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 822 NE 125TH ST STE 100
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5729
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Country | US
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Telephone | 786-238-7313
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Fax |
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Provider Business Mailing Address
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Address Line | 822 NE 125TH ST STE 100
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5729
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Country | US
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Telephone | 786-238-7313
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARLOS CARRAZANA
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Credential | D.C.
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Telephone | 786-877-6923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9890
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License Number State | FL
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