Healthcare Provider Details

I. General information

NPI: 1629854799
Provider Name (Legal Business Name): SOUTH FLORIDA NEURO REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8645 N MILITARY TRL STE 401
WEST PALM BEACH FL
33410-6295
US

IV. Provider business mailing address

8645 N MILITARY TRL STE 401
WEST PALM BEACH FL
33410-6295
US

V. Phone/Fax

Practice location:
  • Phone: 561-320-2702
  • Fax:
Mailing address:
  • Phone: 561-320-2707
  • Fax: 561-467-4179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN PROENCA
Title or Position: OWNER
Credential: PT, DPT, MSCS
Phone: 561-662-5863