MEDICARE: DELRAY GROUP, 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	314000000X	Skilled Nursing Facility	SNF12300962	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629065933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELRAY GROUP, LLC

Provider Business Mailing Address
First Line	:	5430 LINTON BLVD
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6512
Country	:	US
Telephone Number	:	561-495-3188
Fax Number	:	561-495-3190

Provider Business Practice Location Address
First Line	:	5430 LINTON BLVD
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6512
Country	:	US
Telephone Number	:	561-495-3188
Fax Number	:	561-495-3190

Authorized Official
Title or Position	:	REINBURSEMENT
Name	:	MR. NELSON ROBAINA JR.
Credential	:
Telephone Number	:	605-864-9191

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	05/21/2009

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Directions to “DELRAY GROUP, LLC ” Practice Location

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