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General NPI Number Information
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NPI Number | 1992566103
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Entity Type | Organization
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Legal Business Name | CHILDRENS REHAB LEHIGH LLC
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 3020 LEE BLVD STE 11
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-2438
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Country | US
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Telephone | 239-674-7439
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Fax |
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Provider Business Mailing Address
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Address Line | 4143 SW 74TH CT STE B
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City | MIAMI
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State | FL
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Zip | 33155-4467
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Country | US
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Telephone | 305-622-7575
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. YOLEIDIS GONZALEZ
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Credential |
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Telephone | 786-499-5497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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