Miami Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT16772 Issued in FL

Legal business name

MIAMI REHAB LLC

Practice address

14629 SW 104TH St Ste 148
Miami, FL 33186-2905

Phone

(786) 227-6843

Fax

(786) 227-6708

NPI assigned

Dec 3, 2012

Organization subpart

No

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

Authorized official

Name

Gustavo Gonzalez, P.T.

Title

Managing Member

Phone

(786) 227-6843

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1265777239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14629 SW 104TH ST STE 148",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862905",
            "telephone_number": "786-227-6843",
            "fax_number": "786-227-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14629 SW 104TH ST STE 148",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862905",
            "telephone_number": "786-227-6843",
            "fax_number": "786-227-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "786-227-6843",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Miami, FL
• Providers in Miami, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.