MEDICARE: WITCORF, 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	273Y00000X	Rehabilitation Hospital Unit	104876	FL

General Provider Information

NPI Number	:	1790706984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WITCORF, INC.

Provider Business Mailing Address
First Line	:	1085 KANE CONCOURSE
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2105
Country	:	US
Telephone Number	:	305-962-7155
Fax Number	:	305-861-5558

Provider Business Practice Location Address
First Line	:	1085 KANE CONCOURSE
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2105
Country	:	US
Telephone Number	:	305-962-7155
Fax Number	:	305-861-5558

Authorized Official
Title or Position	:	ASSISTANT ADMINISTRATOR
Name	:	MRS. LISHKA C. WITTELS
Credential	:
Telephone Number	:	305-368-1755

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	08/22/2020

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