Provider Demographics
NPI:1992124739
Name:JM REHABILITATION CENTER CORP
Entity type:Organization
Organization Name:JM REHABILITATION CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRTECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-542-5073
Mailing Address - Street 1:3900 NW 79TH AVE STE 591
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6570
Mailing Address - Country:US
Mailing Address - Phone:786-542-5073
Mailing Address - Fax:305-503-6814
Practice Address - Street 1:3900 NW 79TH AVE STE 591
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6570
Practice Address - Country:US
Practice Address - Phone:786-542-5073
Practice Address - Fax:305-503-6814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9063261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service