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General NPI Number Information
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NPI Number | 1609006253
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Entity Type | Organization
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Legal Business Name | TOTAL REHAB SERVICES INC
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 14411 COMMERCE WAY STE 315
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1532
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Country | US
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Telephone | 305-644-7294
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Fax | 305-644-7295
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Provider Business Mailing Address
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Address Line | 14411 COMMERCE WAY STE 315
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1532
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Country | US
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Telephone | 305-644-7294
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Fax | 305-644-7295
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. HERMAN E. VEGA
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Credential | PHD, AP, LMHC
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Telephone | 305-644-7294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 1113AD301401
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License Number State | FL
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