MEDICARE: MD HEALTHCARE & REHAB

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	261Q00000X	Clinic/Center	MM27455	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HCC9387	OTHER	FL	AGENCY FOR HEALTH CARE

General Provider Information

NPI Number	:	1942563036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MD HEALTHCARE & REHAB

Provider Business Mailing Address
First Line	:	7975 NW 154TH ST
Second Line	:	STE 200
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5863
Country	:	US
Telephone Number	:	305-822-2824
Fax Number	:	305-822-2355

Provider Business Practice Location Address
First Line	:	7975 NW 154TH ST
Second Line	:	STE 200
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5863
Country	:	US
Telephone Number	:	305-822-2824
Fax Number	:	305-822-2355

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JULIO PRADO
Credential	:	PA
Telephone Number	:	305-822-2824

Provider Enumeration Date	:	06/22/2012
Last Update Date	:	06/22/2012

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Directions to “MD HEALTHCARE & REHAB ” Practice Location

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