Provider Demographics
NPI:1316997323
Name:KJ HEALTH THERAPY REHABILITATION, INC.
Entity type:Organization
Organization Name:KJ HEALTH THERAPY REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SILVANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-219-3598
Mailing Address - Street 1:3520 W 18TH AVE
Mailing Address - Street 2:SUITE # 115
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4634
Mailing Address - Country:US
Mailing Address - Phone:305-823-0210
Mailing Address - Fax:
Practice Address - Street 1:3520 W 18TH AVE
Practice Address - Street 2:SUITE # 115
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4634
Practice Address - Country:US
Practice Address - Phone:305-823-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9457Medicare ID - Type UnspecifiedPROVIDER NUMBER