Healthcare Provider Details

I. General information

NPI: 1306388434
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 08/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 PINES BLVD 100
PEMBROKE PINES FL
33024-6455
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 954-241-3692
  • Fax:
Mailing address:
  • Phone: 561-733-5590
  • 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: JOHN PAPA
Title or Position: OWNER
Credential:
Phone: 561-801-2535