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General NPI Number Information
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NPI Number | 1487925814
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Entity Type | Organization
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Legal Business Name | F & J REHABILITATION, INC.
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 4980 W 10TH AVENUE SUITE 201
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City | HIALEAH
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State | FL
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Zip | 33012
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Country | US
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Telephone | 786-334-6170
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Fax | 305-456-6194
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Provider Business Mailing Address
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Address Line | 4980 W 10TH AVENUE SUITE 201
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City | HIALEAH
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State | FL
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Zip | 33012
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Country | US
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Telephone | 786-334-6170
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Fax | 305-456-6194
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUDEL LA O
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Credential |
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Telephone | 786-334-6170
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC9690
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License Number State | FL
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