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General NPI Number Information
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NPI Number | 1164820296
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Entity Type | Organization
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Legal Business Name | CORAL MEDICAL REHAB-CENTER INC.
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 9778 SW 24TH ST
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City | MIAMI
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State | FL
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Zip | 33165-7574
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Country | US
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Telephone | 305-228-7432
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Fax |
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Provider Business Mailing Address
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Address Line | 9778 SW 24TH ST
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City | MIAMI
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State | FL
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Zip | 33165-7574
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Country | US
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Telephone | 305-228-7432
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTONIO E ALFONSO
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Credential |
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Telephone | 305-228-7432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | ME83615
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License Number State | FL
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