MEDICARE: TWO G'S OF BROWARD

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1851342554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWO G'S OF BROWARD

Provider Business Mailing Address
First Line	:	7100 SW 99TH AVE STE 102
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4668
Country	:	US
Telephone Number	:	305-223-6050
Fax Number	:	305-595-0752

Provider Business Practice Location Address
First Line	:	7100 SW 99TH AVE STE 102
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4668
Country	:	US
Telephone Number	:	305-595-2053
Fax Number	:	305-595-0752

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	LIDIA EIRANOVA
Credential	:
Telephone Number	:	305-223-6050

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	09/08/2023

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Directions to “TWO G'S OF BROWARD ” Practice Location

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