MEDICARE: COMPREHAB WELLNESS GROUP INC

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1033163852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHAB WELLNESS GROUP INC

Provider Business Mailing Address
First Line	:	1330 SW 22ND ST
Second Line	:	SUITE 303
City	:	MIAMI
State	:	FL
Zip	:	33145-2929
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 SW 22ND ST
Second Line	:	SUITE 303
City	:	MIAMI
State	:	FL
Zip	:	33145-2929
Country	:	US
Telephone Number	:	305-285-1377
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RANDALL A WESTON
Credential	:
Telephone Number	:	305-285-1377

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/22/2020

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