Healthcare Provider Details
I. General information
NPI: 1992568281
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2632 W INDIANTOWN RD
JUPITER FL
33458-5889
US
IV. Provider business mailing address
4971 LE CHALET BLVD STE 100
BOYNTON BEACH FL
33436-1418
US
V. Phone/Fax
- Phone: 561-437-4310
- Fax:
- Phone: 561-733-5590
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JORGE
GARCIA
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 561-537-4526