MEDICARE: TOTAL REHAB SERVICES 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	1113AD301401	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1235188905	OTHER	FL	MENTAL HEALTH

General Provider Information

NPI Number	:	1609006253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL REHAB SERVICES INC

Provider Business Mailing Address
First Line	:	14411 COMMERCE WAY STE 315
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1532
Country	:	US
Telephone Number	:	305-644-7294
Fax Number	:	305-644-7295

Provider Business Practice Location Address
First Line	:	14411 COMMERCE WAY STE 315
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1532
Country	:	US
Telephone Number	:	305-644-7294
Fax Number	:	305-644-7295

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	DR. HERMAN E. VEGA
Credential	:	PHD, AP, LMHC
Telephone Number	:	305-644-7294

Provider Enumeration Date	:	07/16/2009
Last Update Date	:	05/26/2023

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