Healthcare Provider Details

I. General information

NPI: 1285003632
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NW 82ND AVE STE 204-205
PLANTATION FL
33324-7809
US

IV. Provider business mailing address

4971 LE CHALET BLVD
BOYNTON BEACH FL
33436-1418
US

V. Phone/Fax

Practice location:
  • Phone: 954-947-2167
  • Fax:
Mailing address:
  • Phone: 561-733-5590
  • Fax: 561-740-0714

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