Provider Demographics
NPI:1992244271
Name:ROA REHABILITATION HEALTH SERVICES INC.
Entity type:Organization
Organization Name:ROA REHABILITATION HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:ROA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:786-553-2002
Mailing Address - Street 1:500 SW 130TH TER APT A401
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:786-233-7112
Practice Address - Street 1:500 SW 130TH TER APT A401
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-4098
Practice Address - Country:US
Practice Address - Phone:786-553-2002
Practice Address - Fax:786-233-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22682261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy