Organization
VISTA REHAB CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIANKA DE PAZ (OWNER)
(786) 459-2637
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD STE 1G2, MIAMI, FL 33172-4511
(786) 459-2637
Mailing address
175 FONTAINEBLEAU BLVD STE 1G2, MIAMI, FL 33172-4511
(786) 459-2637
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MA 47653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 47653
PHYSICAL THERAPY
FL
Enumeration date
01/19/2011
Last updated
01/19/2011
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