=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750320156
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABILITATION CENTER OF MIAMI LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2006
-----------------------------------------------------
Last Update Date | 04/27/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 S DIXIE HWY STE 4D
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-856-9000
-----------------------------------------------------
Fax | 305-856-9910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 S DIXIE HWY STE 4D
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-856-9000
-----------------------------------------------------
Fax | 305-856-9910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / PHYSICAL THERAPIST
-----------------------------------------------------
Name | CARINA M WIKLUND SABA
-----------------------------------------------------
Credential | RPT
-----------------------------------------------------
Telephone | 305-856-9000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | PT15261
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------