Provider Demographics
NPI:1215279096
Name:YD MEDICAL REHABILITATION CENTER
Entity type:Organization
Organization Name:YD MEDICAL REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAIRON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-698-2296
Mailing Address - Street 1:4999 W 8TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3409
Mailing Address - Country:US
Mailing Address - Phone:305-698-2296
Mailing Address - Fax:305-698-2295
Practice Address - Street 1:4999 W 8TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3409
Practice Address - Country:US
Practice Address - Phone:305-698-2296
Practice Address - Fax:305-698-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service