| Organization Name: | PHYSICIAN REHAB CENTER INC |
| NPI Number: | 1730479601 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JORGE LUIS LOPEZ (SECRETARY/VP) |
| Mailing Address: | 5801 Nw 151st St Suite 106 Miami Lakes |
| State: | FL US |
| Postal Code: | 330142437 |
| Phone Number: | 3058280455 |
| Fax Number: | 3058288455 |
| NPI Enumeration Date: | 04/13/2011 |
| NPI Last Update Date: | 04/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME17907 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |