# BLUE SKY MEDICAL & REHAB CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BLUE SKY MEDICAL& REHAB CENTER LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548810179
- **Authorized official:** SUSEL CASADO (MANAGER)
- **Authorized official phone:** (786) 360-5306

## Contact information

- **Practice address:** 2337 W 76TH ST, HIALEAH, FL 33016-1842
- **Practice address phone:** (786) 360-5306
- **Practice address fax:** (786) 637-2363
- **Mailing address:** 2337 W 76TH ST, HIALEAH, FL 33016-1842
- **Mailing address phone:** (786) 360-5306
- **Mailing address fax:** (786) 637-2363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 09/16/2019
- **Last updated:** 05/12/2021