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General NPI Number Information
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NPI Number | 1588712780
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Entity Type | Organization
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Legal Business Name | SOUTHWEST MIAMI REHABILITATIVE CENTER, INC.
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Dates
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Enumeration Date | 01/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11180 W FLAGLER ST SUITE 10
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City | MIAMI
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State | FL
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Zip | 33174-1216
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Country | US
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Telephone | 305-234-2957
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Fax |
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Provider Business Mailing Address
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Address Line | 11180 W FLAGLER ST SUITE 10
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City | MIAMI
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State | FL
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Zip | 33174-1216
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Country | US
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Telephone | 305-234-2957
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Fax |
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | LUIS A ALONZO JR.
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Credential | OT
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Telephone | 305-234-2957
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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 |
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License Number State |
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