1255561841 NPI number — M&M REHABILITATION CENTER, INC

Table of content: (NPI 1255561841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255561841 NPI number — M&M REHABILITATION CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M&M REHABILITATION CENTER, 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:
6
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:
1255561841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10250 SW 56TH ST STE A201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33165-7095
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-409-5938
Provider Business Mailing Address Fax Number:
786-558-8947

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10250 SW 56TH ST STE A201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33165-7095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-409-5938
Provider Business Practice Location Address Fax Number:
786-558-8947
Provider Enumeration Date:
07/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DUSU ARMINAN
Authorized Official First Name:
MIGSEY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
786-409-5938

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 108323700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com