Provider Demographics
NPI:1316683535
Name:MIND AND BODY REHAB MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:MIND AND BODY REHAB MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SILMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-448-4938
Mailing Address - Street 1:7925 NW 12TH ST STE 118
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1820
Mailing Address - Country:US
Mailing Address - Phone:786-448-4938
Mailing Address - Fax:
Practice Address - Street 1:7925 NW 12TH ST STE 118
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1820
Practice Address - Country:US
Practice Address - Phone:786-448-4938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIND AND BODY REHAB MEDICAL GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management