{
"Npi": {
"NPI": "1316948722",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "QUALITY CARE REHAB GROUP INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2500 SW 107TH AVE",
"SecondLineMailingAddress": "SUITE 20",
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33165-2470",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-480-9919",
"MailingAddressFaxNumber": "305-480-9925",
"FirstLinePracticeLocationAddress": "2500 SW 107TH AVE",
"SecondLinePracticeLocationAddress": "SUITE 20",
"PracticeLocationAddressCityName": "MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33165-2470",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-480-9919",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/09/2005",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MACHIN",
"AuthorizedOfficialFirstName": "PEDRO",
"AuthorizedOfficialMiddleName": "TOMAS",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "OTR/L",
"AuthorizedOfficialTelephoneNumber": "305-480-9919",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "OT 10360",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT 13065",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}