Organization Name: | C & G REHAB SERV CORP |
NPI Number: | 1700944873 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARQUIMIDES PUPO (PRESIDENT) |
Mailing Address: | 7911 Nw 72nd Ave Suite 118a Medley |
State: | FL US |
Postal Code: | 331662227 |
Phone Number: | 3058636585 |
Fax Number: | 3058636583 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 07/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 686706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |