Blue Angel Rehab, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BLUE ANGEL REHAB, INC.

Practice address

2240 NE 42ND Cir
Homestead, FL 33033-6611

Phone

(786) 253-4870

NPI assigned

May 26, 2017

Last updated

May 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reinier Lopez

Title

Owner

Phone

(786) 253-4870

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495756800000",
    "number": "1588192140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 NE 42ND CIR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330336611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 NE 42ND CIR",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330336611",
            "telephone_number": "786-253-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ANGEL REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-26",
        "last_updated": "2017-05-26",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "REINIER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-253-4870"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Homestead, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; 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.