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General NPI Number Information
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NPI Number | 1477867463
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Entity Type | Organization
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Legal Business Name | EXCELLENT REHABILITATION CENTER INC.
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Dates
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Enumeration Date | 08/02/2010
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Last Update Date | 08/02/2010
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Provider Practice Location Address
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Address Line | 5757 SW 8TH ST STE 201
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City | WEST MIAMI
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State | FL
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Zip | 33144-5060
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Country | US
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Telephone | 305-362-1113
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Fax | 305-362-1115
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Provider Business Mailing Address
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Address Line | 5757 SW 8TH ST STE 201
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City | WEST MIAMI
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State | FL
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Zip | 33144-5060
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Country | US
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Telephone | 305-362-1113
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Fax | 305-362-1115
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDRES SANCHEZ I
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Credential | MA
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Telephone | 305-362-1113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | MA46321
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License Number State | FL
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