1124349865 NPI number — D & K REHAB CENTER 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 1124349865 NPI number — D & K REHAB CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D & K REHAB 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:
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:
1124349865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8360 W FLAGLER ST
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33144-2042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-222-6116
Provider Business Mailing Address Fax Number:
305-222-6119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8360 W FLAGLER ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33144-2042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-222-6116
Provider Business Practice Location Address Fax Number:
305-222-6119
Provider Enumeration Date:
06/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MURO
Authorized Official First Name:
ROLANDO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-222-6116

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  HCC8309 , 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)

  • Identifier: FILE 8574 . This is a "AHCA EXEMPT HCC UNIT" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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