MEDICARE: ELITE MEDICAL CENTER AND REHAB LLC

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

General Provider Information

NPI Number	:	1508658378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE MEDICAL CENTER AND REHAB LLC

Provider Business Mailing Address
First Line	:	900 W 49TH ST STE 300
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3407
Country	:	US
Telephone Number	:	954-208-7398
Fax Number	:	954-208-7399

Provider Business Practice Location Address
First Line	:	900 W 49TH ST STE 300
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3407
Country	:	US
Telephone Number	:	954-208-7398
Fax Number	:	954-208-7399

Authorized Official
Title or Position	:	OWNER
Name	:	OXANDER VALLEJO VILORIO
Credential	:
Telephone Number	:	954-208-7398

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	12/15/2025

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