Provider Demographics
NPI:1982447546
Name:FENIX REHABILITATION THERAPY LLC
Entity type:Organization
Organization Name:FENIX REHABILITATION THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-287-3451
Mailing Address - Street 1:1786 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4714
Mailing Address - Country:US
Mailing Address - Phone:786-287-3451
Mailing Address - Fax:305-964-7823
Practice Address - Street 1:1786 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-4714
Practice Address - Country:US
Practice Address - Phone:786-287-3451
Practice Address - Fax:305-964-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy