Medical Rehab Clinic of Broward LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS8590 Issued in FL

Legal business name

MEDICAL REHAB CLINIC OF BROWARD LLC

Doing business as

Medical Rehab Clinic of Broward

Practice address

1528 NE 4TH Ave
Fort Lauderdale, FL 33304-1036

Phone

(954) 467-8855

Fax

(954) 467-8857

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Charles Harry Richard, D.O.

Title

Medical Director

Phone

(954) 467-8855

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medical Rehab Clinic of Broward Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Family Practice and Rehab, Inc

  • Chiropractor
  • Orlando, FL
  • NPI 1932460342
  NPPES parent name

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1891703351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 NE 4TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041036",
            "telephone_number": "954-467-8855",
            "fax_number": "954-467-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 NE 4TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041036",
            "telephone_number": "954-467-8855",
            "fax_number": "954-467-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL REHAB CLINIC OF BROWARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HARRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-467-8855",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001414000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U2206X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Rehab Clinic of Broward",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Diagnostic Solutions LLC
• Medical Help Family Practice Inc
• Medical Staffing Network Healthcare, LLC (MSN HomeCare)
• Medical Staffing Network, Inc.
• Medical Supplies Distributor, Inc.
• Medical Vitality Clinic LLC
• Celina Medicina, LCSW

• Family Medicine Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.