Healthcare Provider Details

I. General information

NPI: 1922406826
Provider Name (Legal Business Name): COMPREHENSIVE PHYSICAL MEDICINE AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 JOG RD SUITE 100
DELRAY BEACH FL
33446-3808
US

IV. Provider business mailing address

13550 JOG RD SUITE 100
DELRAY BEACH FL
33446-3808
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-5144
  • Fax: 561-496-5201
Mailing address:
  • Phone: 561-496-5144
  • Fax: 561-496-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberL14000182172
License Number StateFL

VIII. Authorized Official

Name: DANIEL E SAGE
Title or Position: CEO
Credential:
Phone: 561-496-5144