Provider Demographics
NPI:1144040791
Name:ES REHAB PROFESSIONAL CENTER, INC
Entity type:Organization
Organization Name:ES REHAB PROFESSIONAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PADRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-536-6196
Mailing Address - Street 1:5600 SW 135TH AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5101
Mailing Address - Country:US
Mailing Address - Phone:786-536-6196
Mailing Address - Fax:
Practice Address - Street 1:5600 SW 135TH AVE STE 216
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5101
Practice Address - Country:US
Practice Address - Phone:786-536-6196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health