MEDICARE: LEON REHABILITATION AND NURSING SERVICES, 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	225XR0403X	Driving and Community Mobility Occupational Therapist	OT14440	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952888612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEON REHABILITATION AND NURSING SERVICES, INC

Provider Business Mailing Address
First Line	:	6701 GARFIELD ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5741
Country	:	US
Telephone Number	:	305-801-0476
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 GARFIELD ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5741
Country	:	US
Telephone Number	:	305-801-0476
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MARITZA MEMBRENO
Credential	:	OT
Telephone Number	:	395-801-0476

Provider Enumeration Date	:	07/25/2018
Last Update Date	:	07/25/2018

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