Healthcare Provider Details
I. General information
NPI: 1396568010
Provider Name (Legal Business Name): REJUV HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2024
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7383 N STATE ROAD 7
PARKLAND FL
33073-4527
US
IV. Provider business mailing address
13555 KILTIE CT
DELRAY BEACH FL
33446-3624
US
V. Phone/Fax
- Phone: 305-395-4411
- Fax: 305-614-0530
- Phone: 305-395-4411
- Fax: 305-614-0530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207NS0135X |
| Taxonomy | Procedural Dermatology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083B0002X |
| Taxonomy | Obesity Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRADLEY
DRURY
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 305-395-4411