Healthcare Provider Details

I. General information

NPI: 1376861294
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 N UNIVERSITY DR STE 100
TAMARAC FL
33321-2902
US

IV. Provider business mailing address

11211 PROSPERITY FARMS RD B-104
PALM BEACH GARDENS FL
33410-1213
US

V. Phone/Fax

Practice location:
  • Phone: 954-722-6551
  • Fax: 954-772-6803
Mailing address:
  • Phone: 561-762-6866
  • Fax: 561-634-3449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN PAPA
Title or Position: PRESIDENT
Credential: D.C.
Phone: 561-801-2535