Organization
ABC PEDIATRIC REHAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EGUIZABAL MSPT (DIRECTOR OF PT)
(786) 261-6752
Entity
Organization
Contact information
Practice address
12970 SW 117TH ST, MIAMI, FL 33186-4611
(786) 261-6752
Mailing address
12970 SW 117TH ST, MIAMI, FL 33186-4611
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
01/17/2008
Last updated
01/17/2008
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