Healthcare Provider Details

I. General information

NPI: 1437076247
Provider Name (Legal Business Name): REBIRTH INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 VISTA PKWY # 291
WEST PALM BEACH FL
33411-2706
US

IV. Provider business mailing address

2101 VISTA PKWY # 291
WEST PALM BEACH FL
33411-2706
US

V. Phone/Fax

Practice location:
  • Phone: 561-294-7473
  • Fax:
Mailing address:
  • Phone: 561-294-7473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PHARA C METELLUS
Title or Position: OWNER
Credential: NP
Phone: 561-460-3623