Healthcare Provider Details

I. General information

NPI: 1720455769
Provider Name (Legal Business Name): REBECCA ZURBUCHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 PONCE DE LEON ST
ROYAL PALM BEACH FL
33411-1213
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 561-791-9090
  • Fax: 561-791-9071
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 NumberCH 11595
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH 11595
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: