Organization
PREMIER REHABILITATION GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDICE CARBONEL LMT (PRESIDENT-OWNER)
(305) 822-6812
Entity
Organization
Contact information
Practice address
7980 NW 155TH ST, STE A, MIAMI LAKES, FL 33016-5884
(305) 822-6812
(305) 822-6813
Mailing address
7980 NW 155TH ST, STE A, MIAMI LAKES, FL 33016-5884
(305) 822-6812
(305) 822-6813
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
MM26565
FL
Other
Enumeration date
03/19/2011
Last updated
03/19/2011
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