Provider Demographics
NPI:1245475284
Name:PROGRESS REHABILITATION, INC.
Entity type:Organization
Organization Name:PROGRESS REHABILITATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:AGUIAR
Authorized Official - Suffix:SR
Authorized Official - Credentials:ETC
Authorized Official - Phone:305-480-1000
Mailing Address - Street 1:320 SW 109TH AVE
Mailing Address - Street 2:320
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1332
Mailing Address - Country:US
Mailing Address - Phone:305-480-1000
Mailing Address - Fax:305-480-5058
Practice Address - Street 1:320 SW 109TH AVE
Practice Address - Street 2:320
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1332
Practice Address - Country:US
Practice Address - Phone:305-480-1000
Practice Address - Fax:305-480-5058
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESS REHABILITATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40680174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty