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General NPI Number Information
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NPI Number | 1194778779
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Entity Type | Organization
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Legal Business Name | GOOD CARE REHABILITATIVE SERVICE CORP
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5040 NW 7TH ST SUITE 470
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City | MIAMI
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State | FL
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Zip | 33126-3422
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Country | US
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Telephone | 305-476-0102
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Fax | 305-476-0908
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Provider Business Mailing Address
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Address Line | 5040 NW 7TH ST SUITE 470
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City | MIAMI
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State | FL
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Zip | 33126-3422
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Country | US
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Telephone | 305-476-0102
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Fax | 305-476-0908
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JESUS FELIPE
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Credential |
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Telephone | 305-476-0102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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