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General NPI Number Information
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NPI Number | 1184655656
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Entity Type | Organization
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Legal Business Name | MED DIAGNOSTIC REHAB OF SOUTH FLORIDA INC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 2462 N FEDERAL HWY
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-6812
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Country | US
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Telephone | 954-942-0927
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Fax | 954-942-1110
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Provider Business Mailing Address
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Address Line | 2462 N FEDERAL HWY
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-6812
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Country | US
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Telephone | 954-942-0927
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Fax | 954-942-1110
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICH HOFFMAN
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Credential | PTA,MHSA, BBA
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Telephone | 561-312-1120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 686684
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License Number State | FL
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