Provider Demographics
NPI:1306911862
Name:C & W REHABILITATION MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:C & W REHABILITATION MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHEFFY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-631-6666
Mailing Address - Street 1:4530 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2307
Mailing Address - Country:US
Mailing Address - Phone:305-444-1449
Mailing Address - Fax:305-444-0387
Practice Address - Street 1:4530 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2307
Practice Address - Country:US
Practice Address - Phone:305-444-1449
Practice Address - Fax:305-444-0387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLE6976261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC6336OtherHEALTH CARE CLINIC
FLHCC6336OtherHEALTH CARE CLINIC