1902199367 NPI number — PROFESSIONAL REHABILITATION SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902199367 NPI number — PROFESSIONAL REHABILITATION SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL REHABILITATION SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902199367
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11285 SW 211TH ST
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33189-2211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-227-5515
Provider Business Mailing Address Fax Number:
786-227-5516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11285 SW 211TH ST
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33189-2211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-227-5515
Provider Business Practice Location Address Fax Number:
786-227-5516
Provider Enumeration Date:
05/18/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AMARAL
Authorized Official First Name:
YOELIS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
786-227-5515

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)