=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336438134
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OCHUN REHABILITATION CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2011
-----------------------------------------------------
Last Update Date | 04/01/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 85 GRAND CANAL DR STE 306
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33144-2569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-235-4826
-----------------------------------------------------
Fax | 786-235-4827
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 85 GRAND CANAL DR STE 306
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33144-2569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-235-4826
-----------------------------------------------------
Fax | 786-235-4827
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MASSAGE THERAPIST
-----------------------------------------------------
Name | DOMINGO ARMAS
-----------------------------------------------------
Credential | M.A
-----------------------------------------------------
Telephone | 786-235-4826
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------