Organization
SUNSTATE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY TISHMAN DC (MGR)
(561) 487-7200
Entity
Organization
Contact information
Practice address
58 NE 167TH ST, MIAMI, FL 33162-3401
(305) 956-7787
(305) 956-7716
Mailing address
58 NE 167TH ST, MIAMI, FL 33162-3401
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/18/2010
Last updated
07/29/2011
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