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General NPI Number Information
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NPI Number | 1437076247
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Entity Type | Organization
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Legal Business Name | REBIRTH INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 2101 VISTA PKWY # 291
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-2706
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Country | US
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Telephone | 561-294-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 VISTA PKWY # 291
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-2706
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Country | US
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Telephone | 561-294-7473
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHARA C METELLUS
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Credential | NP
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Telephone | 561-460-3623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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