Organization
CLEVELAND REHAB CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA C RIVAS DC (PRESIDENT)
(239) 288-5647
Entity
Organization
Contact information
Practice address
3049 CLEVELAND AVE, SUITE 130, FORT MYERS, FL 33901-7041
(239) 288-5647
(239) 288-5654
Mailing address
3049 CLEVELAND AVE, SUITE 130, FORT MYERS, FL 33901-7041
(239) 288-5647
(239) 288-5654
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC 9451
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FILE 9821
AHCA EXEMPT HCC UNIT
FL
Enumeration date
10/18/2011
Last updated
10/18/2011
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