Premier Rehabilitation Group, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

MM26565 Issued in FL

Legal business name

PREMIER REHABILITATION GROUP, LLC

Practice address

7980 NW 155TH St
Ste a
Miami Lakes, FL 33016-5884

Phone

(305) 822-6812

Fax

(305) 822-6813

NPI assigned

Mar 19, 2011

Last updated

Mar 19, 2011By 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

Lidice Carbonel, LMT

Title

President-Owner

Phone

(305) 822-6812

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300492800000",
    "number": "1912206772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7980 NW 155TH ST",
            "address_2": "STE A",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165884",
            "telephone_number": "305-822-6812",
            "fax_number": "305-822-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7980 NW 155TH ST",
            "address_2": "STE A",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165884",
            "telephone_number": "305-822-6812",
            "fax_number": "305-822-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER REHABILITATION GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-19",
        "last_updated": "2011-03-19",
        "status": "A",
        "authorized_official_last_name": "CARBONEL",
        "authorized_official_first_name": "LIDICE",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "305-822-6812",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "MM26565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Miami Lakes, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2011; 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.