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General NPI Number Information
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NPI Number | 1750626131
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Entity Type | Organization
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Legal Business Name | CITY CENTER REHAB CORP
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 7821 CORAL WAY SUITE 132
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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 | 305-696-9966
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Fax | 305-392-1517
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Provider Business Mailing Address
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Address Line | 7821 CORAL WAY SUITE 132
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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 | 305-696-9966
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Fax | 305-392-1517
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARLYS TABARES
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Credential |
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Telephone | 305-696-9966
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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 | 8733
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License Number State | FL
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