Southern Rehabilitation Group LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SOUTHERN REHABILITATION GROUP LLC

Practice address

6447 Miami Lakes Dr E Ste 200E
Miami Lakes, FL 33014-2706

Phone

(786) 319-0748

NPI assigned

Apr 17, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vivian Blanco Lezcano, LMHCNPI 1225489180

Title

Owner

Phone

(786) 319-0748

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vivian Blanco Lezcano

  • Mental Health Counselor
  • Miami, FL
  • NPI 1225489180
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1104489079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6447 MIAMI LAKES DR E STE 200E",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142706",
            "telephone_number": "786-319-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6447 MIAMI LAKES DR E STE 200E",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142706",
            "telephone_number": "786-319-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN REHABILITATION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "BLANCO LEZCANO",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-319-0748",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747907",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Florida Social Services Corp
• South Miami Hospital, Inc
• South West Technics Inc
• Southern Home Care Services, Inc.
• Southern Medical Equipment and Supplies LLC
• Southwest Medical Group, P.a.
• Yaima Soutuyo
• Stanislaw Anthony Sowinski Jr., PT, DPT
• Spacekids Behavioral Therapy, LLC.
• Specialty Smiles PLLC

• Developmental Disabilities Clinic/Center in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.