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General NPI Number Information
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NPI Number | 1588959266
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Entity Type | Organization
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Legal Business Name | IMPERIAL REHABILITATION & SPA
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 1 GLEN ROYAL PKWY SUITE # 301
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City | MIAMI
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State | FL
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Zip | 33125-5287
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Country | US
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Telephone | 305-817-5538
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Fax | 305-817-5546
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Provider Business Mailing Address
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Address Line | 1 GLEN ROYAL PKWY SUITE # 301
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City | MIAMI
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State | FL
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Zip | 33125-5287
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Country | US
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Telephone | 305-817-5538
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Fax | 305-817-5546
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUAN C GARCIA
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Credential | M.A.
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Telephone | 305-817-5538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MM27027
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License Number State | FL
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