Healthcare Provider Details

I. General information

NPI: 1386839256
Provider Name (Legal Business Name): WELLNESS REHAB USA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 FENTON DR
DELRAY BEACH FL
33445-3555
US

IV. Provider business mailing address

1519 FENTON DR
DELRAY BEACH FL
33445-3555
US

V. Phone/Fax

Practice location:
  • Phone: 561-703-5115
  • Fax:
Mailing address:
  • Phone: 561-703-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 011547
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPT011547
License Number StateFL

VIII. Authorized Official

Name: MISS ROSMIRA ESTHER RAMIREZ
Title or Position: PRESIDENT
Credential: PT-CWS-CFO
Phone: 561-703-5115