Organization
K & I REHAB MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNER GUTIERREZ MASSAGE THERAPIST (PRESIDENT OWNER)
(786) 423-2690
Entity
Organization
Contact information
Practice address
1414 N.W. 107TH AVENUE, SUITE 201, MIAMI, FL 33172
(786) 423-2690
(305) 675-2668
Mailing address
1414 N.W. 107TH AVENUE, SUITE 201, MIAMI, FL 33172
(786) 423-2690
(305) 675-2668
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC9345
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FILE# 9699
AHCA EXEMPT HCC UNIT
FL
Enumeration date
09/09/2011
Last updated
09/09/2011
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