Healthcare Provider Details

I. General information

NPI: 1780316018
Provider Name (Legal Business Name): ROYAL PALM BEACH REHAB, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 S DILLARD ST
WINTER GARDEN FL
34787-3523
US

IV. Provider business mailing address

4971 LE CHALET BLVD STE 100
BOYNTON BEACH FL
33436-1418
US

V. Phone/Fax

Practice location:
  • Phone: 407-614-8898
  • Fax: 407-634-3207
Mailing address:
  • Phone: 561-537-4526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JORGE GARCIA
Title or Position: MANAGER
Credential:
Phone: 561-537-4526