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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1902328511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL PALM BEACH REHAB, CORP

Provider Business Mailing Address
First Line	:	11211 PROSPERITY FARMS RD STE B104
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3453
Country	:	US
Telephone Number	:	561-537-4526
Fax Number	:	561-634-3449

Provider Business Practice Location Address
First Line	:	3355 BURNS RD STE 304
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4357
Country	:	US
Telephone Number	:	561-588-9912
Fax Number	:

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

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	09/27/2017

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