MEDICARE: WELLNESS REHAB USA, 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	251E00000X	Home Health Agency	PT011547	FL
2	225100000X	Physical Therapist	PT 011547	FL

General Provider Information

NPI Number	:	1386839256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS REHAB USA, INC

Provider Business Mailing Address
First Line	:	1519 FENTON DR
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3555
Country	:	US
Telephone Number	:	561-703-5115
Fax Number	:

Provider Business Practice Location Address
First Line	:	1519 FENTON DR
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3555
Country	:	US
Telephone Number	:	561-703-5115
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ROSMIRA ESTHER RAMIREZ
Credential	:	PT-CWS-CFO
Telephone Number	:	561-703-5115

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	09/10/2013

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