Organization
SPECIFIC REHAB SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDELARIA PATERNINA PHYSICAL THERAPY (PRESIDENT)
(786) 506-6760
Entity
Organization
Contact information
Practice address
1435 W 49TH PL STE 301, HIALEAH, FL 33012-3147
(305) 392-1216
(305) 513-5130
Mailing address
1435 W 49TH PL STE 301, HIALEAH, FL 33012-3147
(305) 392-1216
(305) 513-5130
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC4406
AHCA EXEMPTION
FL
Enumeration date
09/02/2016
Last updated
09/12/2019
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