Provider Demographics
NPI:1720143332
Name:FLORIDA REHAB PROFESSIONALS
Entity type:Organization
Organization Name:FLORIDA REHAB PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOREZ-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-446-1098
Mailing Address - Street 1:401 MIRACLE MILE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4930
Mailing Address - Country:US
Mailing Address - Phone:305-446-1098
Mailing Address - Fax:305-446-1638
Practice Address - Street 1:401 MIRACLE MILE
Practice Address - Street 2:SUITE 403
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4930
Practice Address - Country:US
Practice Address - Phone:305-446-1098
Practice Address - Fax:305-446-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888300900Medicaid