| Reserva Rehab Center | |
|
1414 Nw 107th Ave Ste 410 Sweetwater FL 33172-2743 | |
| (786) 608-8580 | |
| Not Available |
| Full Name | Reserva Rehab Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1414 Nw 107th Ave Ste 410, Sweetwater, Florida |
| Authorized Official Name and Position | Yadira Montey Villazon (PRESIDENT) |
| Authorized Official Contact | 3056605743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reserva Rehab Center 1414 Nw 107th Ave Ste 410 Sweetwater FL 33172-2743 Ph: (786) 608-8580 | Reserva Rehab Center 1414 Nw 107th Ave Ste 410 Sweetwater FL 33172-2743 Ph: (786) 608-8580 |
| NPI Number | 1134703820 |
|---|---|
| Provider Enumeration Date | 05/08/2021 |
| Last Update Date | 08/14/2023 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 1254723844 |
|---|---|
| Medicare Enrollment ID | O20220111000756 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134703820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Josefa L Binker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487603353 PECOS PAC ID: 5496659765 Enrollment ID: I20031120000124 |
| Provider Name | Thomas Richard Lange |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952731762 PECOS PAC ID: 8426325127 Enrollment ID: I20170601000537 |
| Provider Name | Imara A Paramo |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992079123 PECOS PAC ID: 9638424880 Enrollment ID: I20180612002720 |
| Provider Name | Eva D Repetti |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841889086 PECOS PAC ID: 1557751237 Enrollment ID: I20211213001199 |
| Provider Name | Mayelin Morales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790220911 PECOS PAC ID: 4688067648 Enrollment ID: I20220215002658 |
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