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NPI Code Detail

MEDICARE: SOUTH BROWARD REHAB SERVICES LLC

MEDICARE: SOUTH BROWARD REHAB SERVICES LLC
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
1261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number : 1891725453
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH BROWARD REHAB SERVICES LLC
Provider Business Mailing Address
First Line : 2021 W 62ND ST
Second Line :
City : HIALEAH
State : FL
Zip : 33016-2678
Country : US
Telephone Number : 305-698-0096
Fax Number : 305-698-0098
Provider Business Practice Location Address
First Line : 2021 W 62ND ST
Second Line :
City : HIALEAH
State : FL
Zip : 33016-2678
Country : US
Telephone Number : 305-698-0096
Fax Number : 305-698-0098
Authorized Official
Title or Position : MANAGER
Name : BENJAMIN A VALDES
Credential :
Telephone Number : 305-698-0096
Provider Enumeration Date : 07/03/2006
Last Update Date : 11/21/2008

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Directions to “SOUTH BROWARD REHAB SERVICES LLC ” Practice Location

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