Healthcare Provider Details

I. General information

NPI: 1770386898
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6522 S KANNER HWY
STUART FL
34997-6396
US

IV. Provider business mailing address

6415 LAKE WORTH RD STE 302
GREENACRES FL
33463-2906
US

V. Phone/Fax

Practice location:
  • Phone: 561-570-2501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JORGE GARCIA
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 305-606-0337