Provider Demographics
NPI:1346484623
Name:IRC INTEGRAL REHABILITATION CENTER
Entity type:Organization
Organization Name:IRC INTEGRAL REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-273-6939
Mailing Address - Street 1:6802 W HILLSBOROUGH AVE
Mailing Address - Street 2:SUIT 13
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634
Mailing Address - Country:US
Mailing Address - Phone:813-881-1747
Mailing Address - Fax:
Practice Address - Street 1:6802 W HILLSBOROUGH AVE
Practice Address - Street 2:SUIT 13
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634
Practice Address - Country:US
Practice Address - Phone:813-881-1747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty