OrganizationPrime Rehab Medical Center CorpClinic/CenterAmbulatory Health Care FacilitiesPractice Address1140 W 50th St, Ste 311, Hialeah, FL 33012-3440(786) 370-1659PECOS EnrollmentBased on the most recent information from CMS, provider Prime Rehab Medical Center Corp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1538566948Provider TypeOrganizationFull NamePrime Rehab Medical Center CorpSubpartNoEnumeration Date12/1/2014Last Updated12/1/2014Contact InformationPractice LocationPractice Address1140 W 50th St, Ste 311, Hialeah, FL 33012-3440Phone(786) 370-1659Fax(786) 370-1659Mailing LocationMailing Address1140 W 50th St, Ste 311, Hialeah, FL 33012-3440Phone(786) 370-1659Fax(786) 370-1659Authorized OfficialNameGonzalez, Blanca N (Medical Director)Phone(786) 370-1659Provider TaxonomiesCodeDescriptionLicenseCode261QH0100XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseME106369Florida