MEDICARE: ADVANCED MEDICAL OFFICE REHABILITATION, 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	261Q00000X	Clinic/Center	HHC5402	FL

General Provider Information

NPI Number	:	1245311968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL OFFICE REHABILITATION, INC.

Provider Business Mailing Address
First Line	:	6916 NW 72ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33166-3036
Country	:	US
Telephone Number	:	305-888-0324
Fax Number	:

Provider Business Practice Location Address
First Line	:	6916 NW 72ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33166-3036
Country	:	US
Telephone Number	:	305-888-0324
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER/MASSAGE THERAPIST
Name	:	MR. JUAN CARLOS PEREZ
Credential	:
Telephone Number	:	305-888-0324

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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