MEDICARE: PALM REHABILITATION CENTER, INC.

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	225100000X	Physical Therapist	HCC4519	FL

General Provider Information

NPI Number	:	1295897536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM REHABILITATION CENTER, INC.

Provider Business Mailing Address
First Line	:	9900 STIRLING RD STE 303
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8066
Country	:	US
Telephone Number	:	954-432-8872
Fax Number	:	954-432-9913

Provider Business Practice Location Address
First Line	:	9900 STIRLING RD STE 303
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8066
Country	:	US
Telephone Number	:	954-432-8872
Fax Number	:	954-432-9913

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KENNETH BERG
Credential	:
Telephone Number	:	954-748-7474

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	10/24/2023

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