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General NPI Number Information
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NPI Number | 1164698296
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Entity Type | Organization
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Legal Business Name | ULTIMATECARE REHAB & WELLNESS INSTITUTE, LLC
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 5341 W ATLANTIC AVE STE 303
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8166
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Country | US
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Telephone | 561-495-6911
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Fax | 561-495-6910
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Provider Business Mailing Address
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Address Line | 5341 W ATLANTIC AVE STE 303
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8166
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Country | US
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Telephone | 561-495-6911
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Fax | 561-495-6910
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | ELVIS E. LOPEZ
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Credential | MSPT
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Telephone | 561-495-6911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | PT22428
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License Number State | FL
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