Provider Demographics
NPI:1427167048
Name:T & R REHAB, INC.
Entity type:Organization
Organization Name:T & R REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:DEL CARMEN
Authorized Official - Last Name:REVERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-8889
Mailing Address - Street 1:19242 SW 65TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33332-3361
Mailing Address - Country:US
Mailing Address - Phone:954-680-3712
Mailing Address - Fax:
Practice Address - Street 1:3130 W 84TH ST
Practice Address - Street 2:UNIT 7
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4907
Practice Address - Country:US
Practice Address - Phone:305-821-8889
Practice Address - Fax:305-824-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT20401Medicare UPIN