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General NPI Number Information
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NPI Number | 1922174606
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Entity Type | Organization
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Legal Business Name | MEDLEY PAIN AND REHABILITATION CENTER INC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 7911 NW 72ND AVE STE 103
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City | MEDLEY
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State | FL
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Zip | 33166-2227
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Country | US
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Telephone | 305-805-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 7911 NW 72ND AVE STE 103
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City | MEDLEY
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State | FL
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Zip | 33166-2227
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Country | US
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Telephone | 305-805-0133
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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. YADIRA GUTIERREZ
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Credential |
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Telephone | 305-805-0133
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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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