Organization
BOULLON REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE RUIZ (OWNER)
(786) 360-6577
Entity
Organization
Contact information
Practice address
2450 SW 137TH AVE, SUITE 203, MIAMI, FL 33175-8802
(786) 360-6577
(786) 636-6964
Mailing address
2450 SW 137TH AVE, SUITE 203, MIAMI, FL 33175-8802
(786) 360-6577
(786) 636-6964
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC12163
FL
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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