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General NPI Number Information
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NPI Number | 1386173656
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Entity Type | Organization
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Legal Business Name | PREMIER MEDICAL REHAB GROUP LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 11411 ARMSDALE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32218-3311
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Country | US
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Telephone | 904-714-3793
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Fax |
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Provider Business Mailing Address
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Address Line | 12864 BISCAYNE BLVD # 442
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORDAN KLEIN
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Credential | MD
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Telephone | 717-712-3617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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