MEDICARE: SYSTEMS & STRUCTURE REHAB 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	261QM3000X	Medically Fragile Infants and Children Day Care	60081007	FL
2	261QP2000X	Physical Therapy Clinic/Center	585246-3	FL
3	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629099734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYSTEMS & STRUCTURE REHAB CENTER INC.

Provider Business Mailing Address
First Line	:	4715 NW 157TH ST STE 111-119
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-6435
Country	:	US
Telephone Number	:	305-342-2481
Fax Number	:	800-603-8864

Provider Business Practice Location Address
First Line	:	4715 NW 157TH ST STE 111-119
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-6435
Country	:	US
Telephone Number	:	305-342-2481
Fax Number	:	800-603-8864

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ALIETTE NEYRA
Credential	:
Telephone Number	:	305-342-2481

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	07/23/2021

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