Provider Demographics
NPI:1083264220
Name:MIAMI REHAB AND WELLNESS CENTER INC
Entity type:Organization
Organization Name:MIAMI REHAB AND WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:JOVANOV
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:305-631-2106
Mailing Address - Street 1:7805 CORAL WAY STE 127
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6557
Mailing Address - Country:US
Mailing Address - Phone:305-631-2106
Mailing Address - Fax:305-631-2108
Practice Address - Street 1:7805 SW 24TH ST STE 127
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6557
Practice Address - Country:US
Practice Address - Phone:305-631-2106
Practice Address - Fax:305-631-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty