MEDICARE: ROYAL PALM PHYSICAL THERAPY, 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1508019985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL PALM PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	1188 ROYAL PALM BEACH BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1672
Country	:	US
Telephone Number	:	561-383-8080
Fax Number	:	561-383-8060

Provider Business Practice Location Address
First Line	:	1188 ROYAL PALM BEACH BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1672
Country	:	US
Telephone Number	:	561-383-8080
Fax Number	:	561-383-8060

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JULIA CORINELLA
Credential	:
Telephone Number	:	561-383-8080

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	10/29/2008

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