=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669402012
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORTHO AND REHABILITATION MEDICAL CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2006
-----------------------------------------------------
Last Update Date | 08/18/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7171 SW 24TH ST STE 316
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33155-1692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-762-2415
-----------------------------------------------------
Fax | 786-762-2418
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7171 SW 24TH ST STE 316
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33155-1692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-762-2415
-----------------------------------------------------
Fax | 786-762-2418
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT OWNER
-----------------------------------------------------
Name | YANELY MARIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-762-2415
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------