Provider Demographics
NPI:1699729780
Name:CLINICAL REHAB CENTER
Entity type:Organization
Organization Name:CLINICAL REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTESINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-303-8981
Mailing Address - Street 1:8080 W FLAGLER ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2100
Mailing Address - Country:US
Mailing Address - Phone:305-631-1171
Mailing Address - Fax:305-631-1169
Practice Address - Street 1:8080 W FLAGLER ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2100
Practice Address - Country:US
Practice Address - Phone:305-631-1171
Practice Address - Fax:305-631-1169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5178Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID