Blue Diamon Rehabilitation Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BLUE DIAMON REHABILITATION CENTER LLC

Practice address

4485 Stirling Rd Ste 110
Davie, FL 33314-7517

Phone

(786) 954-2954

NPI assigned

Jul 31, 2020

Last updated

Apr 19, 2021By 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

Antonio Lopez

Title

Ownwer

Phone

(305) 432-6989

Specialties & licenses 1

Addresses

Other names 1

• BLUE DIAMON REHABILITATION CENTER LLC Former legal business name

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1922617323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 STIRLING RD STE 110",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147517",
            "telephone_number": "786-954-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 STIRLING RD STE 110",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147517",
            "telephone_number": "786-954-2954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12690 NW 1st Ct",
            "address_purpose": "LOCATION",
            "city": "North Miami",
            "state": "FL",
            "postal_code": "331684608",
            "country_code": "US",
            "telephone_number": "786-954-2954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE DIAMON REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-31",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNWER",
        "authorized_official_telephone_number": "305-432-6989"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUE DIAMON REHABILITATION CENTER LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "BLUE DIAMON REHABILITATION CENTER LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapy Clinic/Center in Davie, FL
• Providers in Davie, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.