Healthcare Provider Details

I. General information

NPI: 1205213634
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9325 GLADES RD STE 104
BOCA RATON FL
33434-3988
US

IV. Provider business mailing address

4971 LECHALET BLVD SUITE 100
BOYNTON BEACH FL
33436
US

V. Phone/Fax

Practice location:
  • Phone: 561-513-8380
  • Fax:
Mailing address:
  • Phone: 561-733-5590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOHN PAPA
Title or Position: OWNER
Credential: D.C.
Phone: 561-801-2535