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General NPI Number Information
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NPI Number | 1245521079
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Entity Type | Organization
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Legal Business Name | MILITARY TRAIL REHAB & THERAPY CENTER
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 925 S MILITARY TRL SUITE D6
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-3977
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Country | US
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Telephone | 561-688-8789
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Fax |
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Provider Business Mailing Address
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Address Line | 925 S MILITARY TRL SUITE D6
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-3977
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Country | US
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Telephone | 561-688-8789
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ABEL ACEBO
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Credential |
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Telephone | 561-688-8789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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