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General NPI Number Information
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NPI Number | 1407963721
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Entity Type | Organization
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Legal Business Name | MAX REHABILITATION CENTER,INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 1255 W 46TH ST SUITE # 7 - A
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City | HIALEAH
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State | FL
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Zip | 33012-3283
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Country | US
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Telephone | 305-828-4201
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Fax | 305-828-4203
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Provider Business Mailing Address
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Address Line | 1255 W 46TH ST STE 7-A
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City | HIALEAH
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State | FL
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Zip | 33012-3257
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Country | US
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Telephone | 305-828-4201
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Fax | 305-828-4203
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MISS LUIS F VERDECIA
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Credential | MD
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Telephone | 305-828-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 462200-8
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License Number State | FL
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