Healthcare Provider Details

I. General information

NPI: 1093808479
Provider Name (Legal Business Name): PROFESSIONAL TOUCH REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HYPOLUXO RD SUITE 104
LANTANA FL
33462-4271
US

IV. Provider business mailing address

1111 HYPOLUXO RD 107
LANTANA FL
33462-4271
US

V. Phone/Fax

Practice location:
  • Phone: 561-557-5702
  • Fax: 561-557-5662
Mailing address:
  • Phone: 561-583-3400
  • Fax: 561-585-0079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN L NEMEROFSKY
Title or Position: VICE-PRESIDENT
Credential: M.D.
Phone: 561-586-3400