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General NPI Number Information
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NPI Number | 1780119941
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Entity Type | Organization
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Legal Business Name | EFFECTIVE REHAB & WELLNES
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 50 NW 15TH ST 106
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City | HOMESTEAD
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State | FL
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Zip | 33030-4266
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Country | US
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Telephone | 786-553-0592
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Fax |
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Provider Business Mailing Address
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Address Line | 50 NW 15TH ST 106
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City | HOMESTEAD
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State | FL
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Zip | 33030-4266
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Country | US
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Telephone | 786-553-0592
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VALERIE LOPEZ
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Credential | DPT
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Telephone | 786-553-0592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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