MEDICARE: TRI-COUNTY REHABILITATION 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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)		FL

General Provider Information

NPI Number	:	1871555631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-COUNTY REHABILITATION INC

Provider Business Mailing Address
First Line	:	3121 W HALLANDALE BEACH BLVD
Second Line	:	109
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33009-5149
Country	:	US
Telephone Number	:	786-331-9760
Fax Number	:	786-331-9761

Provider Business Practice Location Address
First Line	:	3121 W HALLANDALE BEACH BLVD
Second Line	:	109
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33009-5149
Country	:	US
Telephone Number	:	786-331-9760
Fax Number	:	786-331-9761

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CARIDAD SUAREZ
Credential	:
Telephone Number	:	786-331-9760

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	05/08/2008

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