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General NPI Number Information
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NPI Number | 1265854202
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Entity Type | Organization
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Legal Business Name | JJ REHABILITATION CENTER CORP.
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 1001 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4103
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Country | US
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Telephone | 786-294-3501
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EZEQUIEL CASAS
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Credential |
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Telephone | 786-294-3501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | HCC7120
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License Number State | FL
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