Provider Demographics
NPI:1578841052
Name:AJ REHAB AND SPA SERVICES INC
Entity type:Organization
Organization Name:AJ REHAB AND SPA SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-2549
Mailing Address - Street 1:2711 SW 137TH AVE
Mailing Address - Street 2:STE 95
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6359
Mailing Address - Country:US
Mailing Address - Phone:786-360-2549
Mailing Address - Fax:
Practice Address - Street 1:2711 SW 137TH AVE
Practice Address - Street 2:STE 95
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6359
Practice Address - Country:US
Practice Address - Phone:786-360-2549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9228261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center