MEDICARE: ROYAL PALM WELLNESS CENTER

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	111N00000X	Chiropractor	CH8680	FL

General Provider Information

NPI Number	:	1477931699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL PALM WELLNESS CENTER

Provider Business Mailing Address
First Line	:	10341 ROYAL PALM BLVD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4817
Country	:	US
Telephone Number	:	954-755-9249
Fax Number	:	954-755-4668

Provider Business Practice Location Address
First Line	:	10341 ROYAL PALM BLVD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4817
Country	:	US
Telephone Number	:	954-755-9249
Fax Number	:	954-755-4668

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JARED S COHEN
Credential	:	DC
Telephone Number	:	954-755-9249

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	05/07/2015

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