Provider Demographics
NPI:1194121012
Name:SPPREHABILITATION, INC
Entity type:Organization
Organization Name:SPPREHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-242-1399
Mailing Address - Street 1:1408 NE 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4535
Mailing Address - Country:US
Mailing Address - Phone:305-242-1399
Mailing Address - Fax:305-242-9442
Practice Address - Street 1:1408 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4535
Practice Address - Country:US
Practice Address - Phone:305-242-1399
Practice Address - Fax:305-242-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)