Provider Demographics
NPI:1699723114
Name:ACE MEDICIAL & REHAB CENTER INC
Entity type:Organization
Organization Name:ACE MEDICIAL & REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANIRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-239-0218
Mailing Address - Street 1:3990 W FLAGER ST
Mailing Address - Street 2:SUITE 101-102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:786-239-0218
Mailing Address - Fax:786-332-2602
Practice Address - Street 1:3990 W FLAGER ST SUITE 101/102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-392-1143
Practice Address - Fax:786-332-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4544261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D1049822OtherCLIA NUMBER
FLHCC4544OtherHEALTH CARE CLINIC LICENS