Organization
KENDALL PROSTHETICS & ORTHOTICS, INC.
Active
Other names
INTEGRATIVE REHABILITATION MEDICAL, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL MAKSUMOV (PRESIDENT)
(917) 502-5273
Entity
Organization
Contact information
Practice address
14221 SW 120TH ST STE 110, MIAMI, FL 33186-7291
(305) 540-3220
(645) 231-2080
Mailing address
14221 SW 120TH ST STE 110, MIAMI, FL 33186-7291
(305) 540-3220
(645) 231-2080
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
POR5
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169843900
U.S. DEPT. OF LABOR OWCP
FL
01
—
226307
AVMED HEALTH PLANS
FL
05
—
951163600
—
FL
01
—
M2289
BLUE CROSS BLUE SHEILD
FL
Enumeration date
02/26/2007
Last updated
05/19/2025
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