Provider Demographics
| NPI: | 1083825012 |
|---|---|
| Name: | NEW HEIGHTS REHAB LLC |
| Entity type: | Organization |
| Organization Name: | NEW HEIGHTS REHAB LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER/ PHYSICAL THERAPIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BLERIM |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | DIBRA |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LMT, PT, DPT |
| Authorized Official - Phone: | 305-322-7728 |
| Mailing Address - Street 1: | 311 NE 8TH ST |
| Mailing Address - Street 2: | SUITE 104 |
| Mailing Address - City: | HOMESTEAD |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33030-4738 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 305-322-7728 |
| Mailing Address - Fax: | 305-245-0352 |
| Practice Address - Street 1: | 311 NE 8TH ST |
| Practice Address - Street 2: | SUITE 104 |
| Practice Address - City: | HOMESTEAD |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33030-4738 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 305-322-7728 |
| Practice Address - Fax: | 305-245-0352 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-05-24 |
| Last Update Date: | 2013-04-03 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| FL | OT10003 | 225XP0200X, 225XF0002X, 225XN1300X, 225X00000X |
| FL | MA25875 | 225700000X |
| FL | OTA11931 | 224Z00000X |
| FL | PT 26142 | 225100000X, 2251P0200X, 2251N0400X, 2251X0800X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | Group - Multi-Specialty | |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
| No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | Group - Multi-Specialty |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Multi-Specialty |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| FL | 891839200 | Medicaid |
