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General NPI Number Information
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NPI Number | 1295971398
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Entity Type | Organization
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Legal Business Name | 36 REHABILITATION CENTER CORP
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Dates
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Enumeration Date | 12/20/2008
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Last Update Date | 12/20/2008
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Provider Practice Location Address
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Address Line | 6595 NW 36TH ST SUITE 119
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6979
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Country | US
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Telephone | 305-871-9981
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Fax | 305-871-9979
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Provider Business Mailing Address
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Address Line | 6595 NW 36TH ST SUITE 119
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6979
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Country | US
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Telephone | 305-871-9981
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Fax | 305-871-9979
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Authorized Official
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Title or Position | DIRECTOR
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Name | HERMANN J DIEHL
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Credential |
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Telephone | 305-871-9981
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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 | CH7483
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License Number State | FL
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