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General NPI Number Information
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NPI Number | 1700152931
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Entity Type | Organization
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Legal Business Name | VITALITY MEDICAL REHAB CENTER INC.
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 04/02/2012
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Provider Practice Location Address
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Address Line | 2121 W OAKLAND PARK BLVD SUITE 4
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1529
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Country | US
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Telephone | 954-274-2846
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 W OAKLAND PARK BLVD SUITE 4
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1529
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Country | US
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Telephone | 954-274-2846
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | PIERRE AUGUSTIN
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Credential |
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Telephone | 954-274-2846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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