Provider Demographics
NPI:1255532305
Name:WEST DIXIE REHAB & MED CENTER INC
Entity type:Organization
Organization Name:WEST DIXIE REHAB & MED CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE-PHILIPPE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-947-2006
Mailing Address - Street 1:14908 WEST DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1018
Mailing Address - Country:US
Mailing Address - Phone:305-947-2006
Mailing Address - Fax:305-947-0097
Practice Address - Street 1:14908 WEST DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1018
Practice Address - Country:US
Practice Address - Phone:305-947-2006
Practice Address - Fax:305-947-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM14042225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========Medicare UPIN