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General NPI Number Information
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NPI Number | 1346268307
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Entity Type | Organization
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Legal Business Name | PINES REHAB, INC.
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 12542 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1713
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Country | US
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Telephone | 954-885-8068
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Fax | 954-885-8086
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Provider Business Mailing Address
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Address Line | 12542 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1713
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Country | US
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Telephone | 954-885-8068
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Fax | 954-885-8086
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDRES SERNA
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Credential |
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Telephone | 954-885-8068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State | FL
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