MEDICARE: E & M REHAB & MEDICAL 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	111NR0400X	Rehabilitation Chiropractor	HCC5174	FL

General Provider Information

NPI Number	:	1487847158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E & M REHAB & MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	1893 NE 164TH ST
Second Line	:	# 100
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4168
Country	:	US
Telephone Number	:	786-274-8010
Fax Number	:	786-274-8020

Provider Business Practice Location Address
First Line	:	1893 NE 164TH ST
Second Line	:	# 100
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4168
Country	:	US
Telephone Number	:	786-274-8010
Fax Number	:	786-274-8020

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EDNER ROUZARD
Credential	:
Telephone Number	:	786-274-8010

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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