Healthcare Provider Details

I. General information

NPI: 1548924293
Provider Name (Legal Business Name): PAM REHABILITATION HOSPITAL OF JUPITER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/28/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5075 INNOVATION WAY
JUPITER FL
33458
US

IV. Provider business mailing address

1828 GOOD HOPE RD STE 102
ENOLA PA
17025-1203
US

V. Phone/Fax

Practice location:
  • Phone: 717-731-9660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY MISITANO
Title or Position: PRESIDENT
Credential:
Phone: 717-731-9660