Provider Demographics
NPI:1861607491
Name:C&CMEDICAL&REHABSERVICESINC
Entity type:Organization
Organization Name:C&CMEDICAL&REHABSERVICESINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:LALAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD NMD DC
Authorized Official - Phone:305-774-1500
Mailing Address - Street 1:3990 W FLAGLER ST
Mailing Address - Street 2:302
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1644
Mailing Address - Country:US
Mailing Address - Phone:305-774-1500
Mailing Address - Fax:305-774-1400
Practice Address - Street 1:3990 W FLAGLER ST
Practice Address - Street 2:302
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1644
Practice Address - Country:US
Practice Address - Phone:305-774-1500
Practice Address - Fax:305-774-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3053111NN1001X
ID208175F00000X
DCNAT1000762175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Not Answered175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96660KOtherSUPPLIER NUMBER
FL96660KOtherSUPPLIER NUMBER
FLK2411Medicare ID - Type UnspecifiedGROUP NUMBER