# VA PHYSICAL REHABILITATION CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518666494
- **Authorized official:** MR. JUAN I VALLES (PRESIDENT/OWNER)
- **Authorized official phone:** (305) 778-6071

## Contact information

- **Practice address:** 974 OLD DIXIE HWY STE A, HOMESTEAD, FL 33030-4933
- **Practice address phone:** (305) 778-6071
- **Practice address fax:** (786) 292-2842
- **Mailing address:** 974 OLD DIXIE HWY STE A, HOMESTEAD, FL 33030-4933
- **Mailing address phone:** (305) 778-6071
- **Mailing address fax:** (786) 292-2842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/28/2023
- **Last updated:** 02/28/2023