Provider Demographics
NPI:1487933149
Name:FIRST GUARDIAN WELLNESS & REHABILITATION CENTER LLC
Entity type:Organization
Organization Name:FIRST GUARDIAN WELLNESS & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-458-8300
Mailing Address - Street 1:9280 SUNSET DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3240
Mailing Address - Country:US
Mailing Address - Phone:786-458-8300
Mailing Address - Fax:786-458-8305
Practice Address - Street 1:9280 SUNSET DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3240
Practice Address - Country:US
Practice Address - Phone:786-458-8300
Practice Address - Fax:786-458-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty