MEDICARE: MILLENNIUM REHABILITATION CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	HCC6739	FL

General Provider Information

NPI Number	:	1245419605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENNIUM REHABILITATION CENTER INC

Provider Business Mailing Address
First Line	:	3676 COLLIN DR
Second Line	:	SUITE 8-9
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-4727
Country	:	US
Telephone Number	:	561-967-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	3676 COLLIN DR
Second Line	:	SUITE 8-9
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-4727
Country	:	US
Telephone Number	:	561-967-4619
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELIN KALICOS
Credential	:
Telephone Number	:	561-967-4619

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	01/18/2012

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