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General NPI Number Information
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NPI Number | 1366149379
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Entity Type | Organization
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Legal Business Name | CLINICA NEUROREHABILITAR LLC
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 2030 S DOUGLAS RD STE 109
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City | CORAL GABLES
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State | FL
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Zip | 33134-4615
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Country | US
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Telephone | 786-961-5799
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 S DOUGLAS RD STE 109
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City | CORAL GABLES
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State | FL
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Zip | 33134-4615
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Country | US
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Telephone | 786-961-5799
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | ANA LUCIA COLLAZOS
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Credential |
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Telephone | 786-646-7256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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