MEDICARE: C & G REHAB SERV CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	686706	FL

General Provider Information

NPI Number	:	1013989680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C & G REHAB SERV CORP

Provider Business Mailing Address
First Line	:	7911 NW 72ND AVE
Second Line	:	STE 118A
City	:	MEDLEY
State	:	FL
Zip	:	33166
Country	:	US
Telephone Number	:	305-863-6585
Fax Number	:	305-863-6583

Provider Business Practice Location Address
First Line	:	7911 NW 72ND AVE
Second Line	:	STE 118A
City	:	MEDLEY
State	:	FL
Zip	:	33166
Country	:	US
Telephone Number	:	305-863-6585
Fax Number	:	305-863-6583

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ARQUIMIDES PUPO
Credential	:
Telephone Number	:	305-863-6585

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	06/18/2008

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Directions to “C & G REHAB SERV CORP ” Practice Location

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