MEDICARE: ROYAL PALM BEACH REHAB, CORP.

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	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891441341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL PALM BEACH REHAB, CORP.

Provider Business Mailing Address
First Line	:	4971 LE CHALET BLVD STE 100
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-1418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 W WATERS AVE STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1866
Country	:	US
Telephone Number	:	813-580-8918
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN PAPA
Credential	:
Telephone Number	:	561-801-2535

Provider Enumeration Date	:	02/23/2022
Last Update Date	:	02/23/2022

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