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General NPI Number Information
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NPI Number | 1790158863
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Entity Type | Organization
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Legal Business Name | CORA REHABILITATION
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 17973 SW 155TH CT
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City | MIAMI
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State | FL
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Zip | 33187-1714
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Country | US
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Telephone | 786-444-1427
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Fax |
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Provider Business Mailing Address
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Address Line | 17973 SW 155TH CT
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City | MIAMI
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State | FL
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Zip | 33187-1714
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | MR. MICHAEL ANTHONY DENIS
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Credential |
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Telephone | 786-444-1427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 26319
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License Number State | FL
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