Organization
EREHAB LLC
Active
Organization
EREHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAM M FUENTES TIRADO (CEO)
(787) 955-0232
Entity
Organization
Contact information
Practice address
831 S STATE ROAD 434, ALTAMONTE SPRINGS, FL 32714-3502
(787) 955-0232
Mailing address
PO BOX 161075, ALTAMONTE SPRINGS, FL 32716-1075
(787) 955-0232
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME114560
FL
Other
Enumeration date
10/08/2014
Last updated
01/21/2022
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