Provider Demographics
NPI:1710858022
Name:DORAL MED AND REHAB
Entity type:Organization
Organization Name:DORAL MED AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:VALENTINA
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-293-8111
Mailing Address - Street 1:1460 NW 107TH AVE # 27-A
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2740
Mailing Address - Country:US
Mailing Address - Phone:305-293-8111
Mailing Address - Fax:305-705-5551
Practice Address - Street 1:1460 NW 107TH AVE # 27-A
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2740
Practice Address - Country:US
Practice Address - Phone:305-293-8111
Practice Address - Fax:305-705-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy