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General NPI Number Information
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NPI Number | 1710275383
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Entity Type | Organization
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Legal Business Name | EXCLUSIVE MEDICAL REHABILITATION INC.
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 7821 CORAL WAY STE 110
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City | MIAMI
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State | FL
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Zip | 33155-6542
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Country | US
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Telephone | 305-381-5736
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Fax | 305-381-5795
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Provider Business Mailing Address
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Address Line | 7821 CORAL WAY STE 110
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City | MIAMI
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State | FL
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Zip | 33155-6542
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Country | US
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Telephone | 305-381-5736
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Fax | 305-381-5795
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Authorized Official
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Title or Position | OWNER / MASSAGE THERAPIST
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Name | MR. IVAN DE JESUS MARTINEZ
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Credential | MA
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Telephone | 305-381-5736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | HCC9325
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License Number State | FL
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