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General NPI Number Information
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NPI Number | 1831642479
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Entity Type | Organization
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Legal Business Name | MIAMI MEDICALREHAB.LLC
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 8494 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33144-4153
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Country | US
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Telephone | 786-399-6597
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Fax | 786-497-3499
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Provider Business Mailing Address
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Address Line | 8494 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33144-4153
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Country | US
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Telephone | 786-399-6597
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Fax | 786-497-3499
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIRIAM LARA
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Credential | M.D
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Telephone | 786-399-6597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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