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General NPI Number Information
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NPI Number | 1679526677
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Entity Type | Organization
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Legal Business Name | J.R.C REHABILITATION MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 555 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3848
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Country | US
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Telephone | 305-836-2474
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Fax | 305-836-2475
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Provider Business Mailing Address
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Address Line | 555 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3848
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Country | US
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Telephone | 305-836-2474
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Fax | 305-836-2475
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ROBERTA ASCENCION
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Credential |
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Telephone | 305-836-2474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | HCC6661
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License Number State | FL
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