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General NPI Number Information
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NPI Number | 1477504496
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Entity Type | Organization
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Legal Business Name | NOVACARE REHABILITATION
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2001 NE 48TH ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-4517
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Country | US
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Telephone | 954-772-1799
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Fax |
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Provider Business Mailing Address
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Address Line | 1944 NW 169TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2036
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Country | US
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Telephone | 305-613-8958
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Fax |
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Authorized Official
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Title or Position | CENTER MANAGER
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Name | MRS. ILEANA BRINIS
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Credential | PHYSICAL THERAPIST
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Telephone | 954-772-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 18749
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License Number State | FL
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