Organization
MIAMI-DADE PHYSICAL REHABILITATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE LUIS CASTILLO (OWNER)
(305) 490-3103
Entity
Organization
Contact information
Practice address
1840 W 49 STREET, HIALEAH, FL 33012
(305) 698-0161
(305) 698-0262
Mailing address
1840 W 49 STREET, SUITE 310, HIALEAH, FL 33012
(305) 698-0161
(305) 698-0262
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
684534
MEDICARE
FL
Enumeration date
10/07/2008
Last updated
10/07/2008
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