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General NPI Number Information
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NPI Number | 1225193915
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Entity Type | Organization
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Legal Business Name | MERCY OUTPATIENT REHABILITATION CLINIC INC
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Dates
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Enumeration Date | 12/25/2006
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 16459 NE 6TH AVE
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City | MIAMI
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State | FL
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Zip | 33162-3675
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Country | US
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Telephone | 305-949-5499
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Fax | 305-949-5461
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Provider Business Mailing Address
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Address Line | 16459 N.E 6TH AVE.
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City | MIAMI
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State | FL
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Zip | 33162-2442
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Country | US
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Telephone | 305-949-5499
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Fax | 305-949-5461
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RONET JEAN
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Credential | MS. PT.
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Telephone | 305-949-5499
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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 | 26
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License Number State | FL
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