Provider Demographics
NPI:1861580359
Name:PINES REHABILITATION INC
Entity type:Organization
Organization Name:PINES REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-796-7199
Mailing Address - Street 1:5617 NW 7TH ST
Mailing Address - Street 2:STE 1502
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3216
Mailing Address - Country:US
Mailing Address - Phone:305-267-4124
Mailing Address - Fax:
Practice Address - Street 1:5617 NW 7TH ST
Practice Address - Street 2:STE 1502
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3216
Practice Address - Country:US
Practice Address - Phone:305-267-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686664Medicare ID - Type Unspecified