Provider Demographics
NPI:1609697077
Name:VIVE REHAB CENTER INC
Entity type:Organization
Organization Name:VIVE REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RORAIMA
Authorized Official - Middle Name:KARINA
Authorized Official - Last Name:VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-322-3536
Mailing Address - Street 1:2555 NW 102ND AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1301
Mailing Address - Country:US
Mailing Address - Phone:786-608-2982
Mailing Address - Fax:
Practice Address - Street 1:2555 NW 102ND AVE STE 109
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1301
Practice Address - Country:US
Practice Address - Phone:786-608-2982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty