MEDICARE: UNIVERSAL REHAB CLINIC CENTER 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1346487725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL REHAB CLINIC CENTER INC

Provider Business Mailing Address
First Line	:	930 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4240
Country	:	US
Telephone Number	:	305-265-5746
Fax Number	:	305-265-5745

Provider Business Practice Location Address
First Line	:	930 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4240
Country	:	US
Telephone Number	:	305-265-5746
Fax Number	:	305-265-5745

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE J RODRIGUEZ
Credential	:
Telephone Number	:	305-265-5746

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	01/07/2009

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