MEDICARE: CORAL MEDICAL 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1841238896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORAL MEDICAL REHAB CENTER INC

Provider Business Mailing Address
First Line	:	9778 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-7574
Country	:	US
Telephone Number	:	305-228-7432
Fax Number	:	305-228-7433

Provider Business Practice Location Address
First Line	:	9778 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-7574
Country	:	US
Telephone Number	:	305-228-7432
Fax Number	:	305-228-7433

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MRS. MIRIAM HERNANDEZ
Credential	:
Telephone Number	:	305-228-7432

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	11/16/2015

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