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General NPI Number Information
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NPI Number | 1578838637
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Entity Type | Organization
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Legal Business Name | SAN LAZARO REHAB CENTER CORP
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 2500 NW 79TH AVE STE 288
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City | DORAL
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State | FL
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Zip | 33122-1090
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Country | US
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Telephone | 305-290-3750
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 NW 79TH AVE STE 288
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City | DORAL
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State | FL
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Zip | 33122-1090
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANIER EMILIO ARCE
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Credential | MA
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Telephone | 786-327-8517
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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 | MA58457
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License Number State | FL
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