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General NPI Number Information
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NPI Number | 1467722637
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Entity Type | Organization
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Legal Business Name | ADRIAN REHAB MOBILE
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 19251 SW 134 AVE RD
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City | MIAMI
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State | FL
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Zip | 33177
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Country | US
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Telephone | 786-234-7889
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Fax | 305-238-4717
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Provider Business Mailing Address
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Address Line | 19251 SW 134 AVE RD
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City | MIAMI
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State | FL
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Zip | 33177
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Country | US
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Telephone | 786-234-7889
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Fax | 305-238-4717
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Authorized Official
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Title or Position | PRESIDENT
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Name | OLGA L CANGAS
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Credential | LMT
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Telephone | 786-234-7889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | MA 65476
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License Number State | FL
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