=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962528349
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN REHAB ASSOCIATES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6092 W OAKLAND PARK BLVD
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33313-1210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-748-7555
-----------------------------------------------------
Fax | 954-748-4910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6092 W OAKLAND PARK BLVD
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33313-1210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-748-7555
-----------------------------------------------------
Fax | 954-748-4910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. SANJIV S SHAH
-----------------------------------------------------
Credential | R.P.T.
-----------------------------------------------------
Telephone | 954-748-7555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | P.T. 00003694
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------