Healthcare Provider Details

I. General information

NPI: 1184154809
Provider Name (Legal Business Name): NVAP REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5922 OKEECHOBEE BLVD
WEST PALM BEACH FL
33417-4324
US

IV. Provider business mailing address

5922 OKEECHOBEE BLVD
WEST PALM BEACH FL
33417-4324
US

V. Phone/Fax

Practice location:
  • Phone: 224-256-4228
  • Fax:
Mailing address:
  • Phone: 224-256-4228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPT32576
License Number StateFL

VIII. Authorized Official

Name: KINJAL JAYMIN DESAI
Title or Position: CEO
Credential: MPT
Phone: 224-256-4228