Provider Demographics
NPI:1871555631
Name:TRI-COUNTY REHABILITATION INC
Entity type:Organization
Organization Name:TRI-COUNTY REHABILITATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-331-9760
Mailing Address - Street 1:3121 W HALLANDALE BEACH BLVD
Mailing Address - Street 2:109
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5149
Mailing Address - Country:US
Mailing Address - Phone:786-331-9760
Mailing Address - Fax:786-331-9761
Practice Address - Street 1:3121 W HALLANDALE BEACH BLVD
Practice Address - Street 2:109
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33009-5149
Practice Address - Country:US
Practice Address - Phone:786-331-9760
Practice Address - Fax:786-331-9761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683233Medicare ID - Type UnspecifiedCORF