Healthcare Provider Details
I. General information
NPI: 1720310352
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2010
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4971 LE CHALET BLVD SUITE 100
BOYNTON BEACH FL
33436-1418
US
IV. Provider business mailing address
4971 LE CHALET BLVD STE 100
BOYNTON BEACH FL
33436-1418
US
V. Phone/Fax
- Phone: 561-733-5590
- Fax: 561-740-0714
- Phone: 561-733-5590
- Fax: 561-740-0714
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
PAPA
Title or Position: PRESIDENT
Credential: D.C.
Phone: 561-801-2535