Provider Demographics
NPI:1871802256
Name:CORAL GABLES REHABILITATION CENTER
Entity type:Organization
Organization Name:CORAL GABLES REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:ALFREDO
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-360-4065
Mailing Address - Street 1:4475 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2562
Mailing Address - Country:US
Mailing Address - Phone:786-360-4065
Mailing Address - Fax:786-360-4080
Practice Address - Street 1:4475 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2562
Practice Address - Country:US
Practice Address - Phone:786-360-4065
Practice Address - Fax:786-360-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM25354261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation