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General NPI Number Information
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NPI Number | 1194074898
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Entity Type | Organization
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Legal Business Name | FENIX REHABILITATION INC
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 913 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33174-3206
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Country | US
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Telephone | 305-266-9511
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Fax | 305-266-9511
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Provider Business Mailing Address
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Address Line | 913 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33174-3206
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Country | US
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Telephone | 305-266-9511
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Fax | 305-266-9511
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS B ALEMAN
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Credential |
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Telephone | 305-266-9511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC9570
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License Number State | FL
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