Provider Demographics
NPI:1962606244
Name:JKR REHAB AND WELLNESS
Entity type:Organization
Organization Name:JKR REHAB AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:KENNY
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-436-1443
Mailing Address - Street 1:9300 NW 25TH ST
Mailing Address - Street 2:STE 106
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1508
Mailing Address - Country:US
Mailing Address - Phone:305-436-1443
Mailing Address - Fax:305-436-1140
Practice Address - Street 1:9300 NW 25TH ST
Practice Address - Street 2:STE 106
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1508
Practice Address - Country:US
Practice Address - Phone:305-436-1443
Practice Address - Fax:305-436-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty