MEDICARE: INDEPENDENT LIFE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)		FL

General Provider Information

NPI Number	:	1023208972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENT LIFE LLC

Provider Business Mailing Address
First Line	:	4047 OCKEECHOBEE BLVD.
Second Line	:	STE 123
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3236
Country	:	US
Telephone Number	:	561-385-0868
Fax Number	:

Provider Business Practice Location Address
First Line	:	4047 OCKEECHOBEE BLVD.
Second Line	:	STE 123
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3236
Country	:	US
Telephone Number	:	561-385-0868
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED.REPRESENTATIVE
Name	:	MRS. PRINCE E. GREEN
Credential	:	O.T
Telephone Number	:	561-385-0868

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	01/02/2010

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1053823088 — SIMPLY CARE SERVICES INC
Practice Location Address:

4047 OKEECHOBEE BLVD STE 110
WEST PALM BEACH, FL
33409-3236

Practice Phone: 561-200-7955
Practice Fax: 561-200-8104

1861051021 — MONICA EADS
Practice Location Address:

4047 OKEECHOBEE BLVD STE 110
WEST PALM BEACH, FL
33409-3236

Practice Phone: 561-686-4552
Practice Fax: 561-686-4528

1417750043 — JESSICA BALANGITAO
Practice Location Address:

4047 OKEECHOBEE BLVD STE 124
WEST PALM BEACH, FL
33409-3236

Practice Phone: 628-833-8424
Practice Fax:

1568343432 — AO FANG
Practice Location Address:

4047 OKEECHOBEE BLVD STE 113
WEST PALM BEACH, FL
33409-3236

Practice Phone: 561-640-3986
Practice Fax:

1922167394 — DR. MARK GEORGE AGRESTI M.D.
Practice Location Address:

2010 CONTINENTAL DR
WEST PALM BEACH, FL
33407-3236

Practice Phone: 561-842-9550
Practice Fax: 561-842-9114

Directions to “INDEPENDENT LIFE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.