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General NPI Number Information
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NPI Number | 1265470330
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Entity Type | Organization
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Legal Business Name | PROREHAB CORP
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2828 SW 22ND ST SUITE # 307
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City | CORAL GABLES
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State | FL
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Zip | 33145-3214
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Country | US
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Telephone | 305-461-3111
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Fax | 305-461-3339
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Provider Business Mailing Address
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Address Line | 2828 CORAL WAY SUITE # 307
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City | CORAL GABLES
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State | FL
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Zip | 33145-3214
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Country | US
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Telephone | 305-461-3111
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Fax | 305-461-3339
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICARDO MALPARTIDA
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Credential | R.P.T
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Telephone | 305-461-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MM15496
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License Number State | FL
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