MEDICARE: PEACE OF MIND REHAB, 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1528011541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND REHAB, INC

Provider Business Mailing Address
First Line	:	2140 WEST FLAGLER ST SUITE 211
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135
Country	:	US
Telephone Number	:	305-644-4022
Fax Number	:	305-644-4028

Provider Business Practice Location Address
First Line	:	2140 WEST FLAGLER ST SUITE 211
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175
Country	:	US
Telephone Number	:	305-644-4022
Fax Number	:	305-644-4028

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JUDITH CALDERON
Credential	:
Telephone Number	:	305-644-4022

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/21/2022

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