MEDICARE: RAUL CAZULO PRESIDENT

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	261QR0400X	Rehabilitation Clinic/Center	MA57595	FL

General Provider Information

NPI Number	:	1144527573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL CAZULO PRESIDENT

Provider Business Mailing Address
First Line	:	2100 W 76TH ST STE 307
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5500
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 W 76TH ST STE 307
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5500
Country	:	US
Telephone Number	:	786-259-4797
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2011
Last Update Date	:	02/21/2011

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Directions to “ RAUL CAZULO PRESIDENT” Practice Location

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