1720389638 NPI number — CARE & SERVICES OF REHABILITATION, 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 1720389638 NPI number — CARE & SERVICES OF REHABILITATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE & SERVICES OF REHABILITATION, 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:
1720389638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
10/18/2018
NPI Reactivation Date:
02/06/2019

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
815 NW 57TH AVENUE
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-618-9669
Provider Business Mailing Address Fax Number:
786-618-9664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
815 NW 57TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-618-9669
Provider Business Practice Location Address Fax Number:
786-618-9664
Provider Enumeration Date:
11/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
VASQUEZ
Authorized Official First Name:
SILVIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
305-610-4100

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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