MEDICARE: GALLOWAY REHABILITATION CENTER 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	225400000X	Rehabilitation Practitioner	4974	FL

General Provider Information

NPI Number	:	1972599413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLOWAY REHABILITATION CENTER INC

Provider Business Mailing Address
First Line	:	4530 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2307
Country	:	US
Telephone Number	:	305-444-1449
Fax Number	:	305-444-0387

Provider Business Practice Location Address
First Line	:	4530 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2307
Country	:	US
Telephone Number	:	305-444-1449
Fax Number	:	305-444-0387

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ILSE E PRADO
Credential	:
Telephone Number	:	305-444-1449

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	11/25/2008

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