Healthcare Provider Details

I. General information

NPI: 1598029225
Provider Name (Legal Business Name): SPECIALIZED THERAPY AND REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 S CONGRESS AVE SUITE 2-C
PALM SPRINGS FL
33406-7617
US

IV. Provider business mailing address

610 MOONDANCER CT
PALM BEACH GARDENS FL
33410-1503
US

V. Phone/Fax

Practice location:
  • Phone: 561-966-2210
  • Fax:
Mailing address:
  • Phone: 561-779-8412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEITH YU
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 561-966-2210