Healthcare Provider Details

I. General information

NPI: 1104964220
Provider Name (Legal Business Name): SB REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S MILITARY TRL SUITE J1
WEST PALM BEACH FL
33415-5720
US

IV. Provider business mailing address

1401 S MILITARY TRL SUITE J1
WEST PALM BEACH FL
33415-5720
US

V. Phone/Fax

Practice location:
  • Phone: 561-436-9597
  • Fax:
Mailing address:
  • Phone: 561-436-9597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEIRAM DE LAS CAGIGAS
Title or Position: PRESIDENT
Credential:
Phone: 561-436-9597