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General NPI Number Information
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NPI Number | 1720363724
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Entity Type | Organization
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Legal Business Name | J.M. REHABILITATION CENTER CORP
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 10300 SW 72ND ST STE 157
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City | MIAMI
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State | FL
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Zip | 33173-3038
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Country | US
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Telephone | 305-603-9908
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Fax | 305-603-9910
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Provider Business Mailing Address
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Address Line | 10300 SW 72ND ST STE 157
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City | MIAMI
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State | FL
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Zip | 33173-3038
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Country | US
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Telephone | 305-603-9908
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Fax | 305-603-9910
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MIRIAM D MATARREDONA
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Credential |
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Telephone | 305-603-9908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | MM26738
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MM26738
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License Number State | FL
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