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General NPI Number Information
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NPI Number | 1497071088
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Entity Type | Organization
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Legal Business Name | QUALITY LIFE REHABILITATION CENTER
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 7760 W 20TH AVE SUITE 1
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City | HIALEAH
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State | FL
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Zip | 33016-1890
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Country | US
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Telephone | 305-819-8755
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Fax | 305-819-8740
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Provider Business Mailing Address
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Address Line | 7760 W 20TH AVE SUITE 1
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City | HIALEAH
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State | FL
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Zip | 33016-1890
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Country | US
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Telephone | 305-819-8755
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Fax | 305-819-8740
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Authorized Official
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Title or Position | OWNER
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Name | MAYRA DOBBIE
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Credential | M.T.
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Telephone | 305-819-8755
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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 | 24504
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License Number State | FL
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