Healthcare Provider Details

I. General information

NPI: 1811688872
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 NW 67TH AVE STE 306
MIAMI LAKES FL
33014-2176
US

IV. Provider business mailing address

4971 LE CHALET BLVD STE 100
BOYNTON BEACH FL
33436-1418
US

V. Phone/Fax

Practice location:
  • Phone: 561-537-4526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JORGE GARCIA
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 561-537-4523