| Organization Name: | SAN JUDE REHAB AND MEDICAL CENTER, CORP. |
| NPI Number: | 1093052193 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DINORAH GONZALEZ (PRESIDENT) |
| Mailing Address: | 8302 Nw 103rd St Suite 202 Hialeah Gardens |
| State: | FL US |
| Postal Code: | 330164697 |
| Phone Number: | 3054566803 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2013 |
| NPI Last Update Date: | 07/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | HCC9743 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |