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Organization

DA PEDIATRIC REHABILITATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA Y ALVAREZ MOTR (OWNER)
(954) 599-9130
Entity
Organization

Contact information

Practice address
13296 NW 18TH ST, PEMBROKE PINES, FL 33028-2502
(954) 599-9130
Mailing address
13296 NW 18TH ST, PEMBROKE PINES, FL 33028-2502
(954) 599-9130

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
OT12685
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004304000
FL
Enumeration date
12/05/2011
Last updated
04/22/2015
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