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NPI Code Detail

MEDICARE: WELLNESS REHAB OF SOUTH FLORIDA INC.

MEDICARE: WELLNESS REHAB OF SOUTH FLORIDA 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
1261QP2000XPhysical Therapy Clinic/Center
2261QP2000XPhysical Therapy Clinic/CenterP17000009153FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P17000009153OTHERFLDOCUMENT NUMBER

General Provider Information

NPI Number : 1114451408
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLNESS REHAB OF SOUTH FLORIDA INC.
Provider Business Mailing Address
First Line : 1600 S FEDERAL HWY STE 550
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-7518
Country : US
Telephone Number : 561-866-7794
Fax Number : 954-657-8358
Provider Business Practice Location Address
First Line : 1600 S FEDERAL HWY STE 550
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-7518
Country : US
Telephone Number : 561-866-7794
Fax Number : 954-657-8358
Authorized Official
Title or Position : CEO
Name : JAIRILENA M VIANA
Credential :
Telephone Number : 561-866-7794
Provider Enumeration Date : 04/13/2017
Last Update Date : 04/13/2017

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Directions to “WELLNESS REHAB OF SOUTH FLORIDA INC. ” Practice Location

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