Healthcare Provider Details

I. General information

NPI: 1528000981
Provider Name (Legal Business Name): SBM REHABILITATION MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 S DIXIE HWY SUITE 101
WEST PALM BEACH FL
33405-4348
US

IV. Provider business mailing address

6300 S DIXIE HWY SUITE 101
WEST PALM BEACH FL
33405-4348
US

V. Phone/Fax

Practice location:
  • Phone: 561-261-1116
  • Fax: 561-261-1118
Mailing address:
  • Phone: 561-261-1116
  • Fax: 561-261-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROMAN PEREZ
Title or Position: PRESIDENT
Credential:
Phone: 561-296-1116