Provider Demographics
NPI:1063973303
Name:AMAZING REHAB. INC.
Entity type:Organization
Organization Name:AMAZING REHAB. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALTRANESE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:786-231-7481
Mailing Address - Street 1:2366 SE 21ST ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-2074
Mailing Address - Country:US
Mailing Address - Phone:786-231-7481
Mailing Address - Fax:786-349-0303
Practice Address - Street 1:2366 SE 21ST ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-2074
Practice Address - Country:US
Practice Address - Phone:786-231-7481
Practice Address - Fax:786-349-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty