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General NPI Number Information
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NPI Number | 1750748430
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Entity Type | Organization
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Legal Business Name | SOLARIS REHAB, LLC
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 14555 SIMS RD
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8547
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Country | US
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Telephone | 561-266-4970
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2386
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City | BONITA SPRINGS
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State | FL
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Zip | 34133-2386
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Country | US
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Telephone | 239-314-5410
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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. DAVID R BOERKOEL
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Credential | MHA, OTR/L
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Telephone | 239-300-2207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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