Provider Demographics
NPI:1730168675
Name:ELITE REHABILITATION INC
Entity type:Organization
Organization Name:ELITE REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-836-4345
Mailing Address - Street 1:900 W 49TH ST
Mailing Address - Street 2:STE 216
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3402
Mailing Address - Country:US
Mailing Address - Phone:305-836-4346
Mailing Address - Fax:305-836-5904
Practice Address - Street 1:900 W 49TH ST
Practice Address - Street 2:STE 216
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3402
Practice Address - Country:US
Practice Address - Phone:305-836-4346
Practice Address - Fax:305-836-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7626OtherMEDICARE LEGACY
FLK7626OtherMEDICARE LEGACY