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General NPI Number Information
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NPI Number | 1184656597
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Entity Type | Organization
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Legal Business Name | LORD PHYSICAL REHABILITATION CENTER
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6595 NW 36TH ST 119
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6979
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Country | US
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Telephone | 305-871-2292
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Fax | 305-871-2293
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Provider Business Mailing Address
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Address Line | 6595 NW 36TH ST 119
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6979
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Country | US
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Telephone | 305-871-2292
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Fax | 305-871-2293
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA DEL CARMEN NAVARRO
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Credential |
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Telephone | 305-871-2292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | HCC6501
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License Number State | FL
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