MEDICARE: ROYAL PALM HEALTH 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1801412788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL PALM HEALTH INC.

Provider Business Mailing Address
First Line	:	3685 DAVIE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3439
Country	:	US
Telephone Number	:	754-216-0183
Fax Number	:

Provider Business Practice Location Address
First Line	:	3685 DAVIE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-3439
Country	:	US
Telephone Number	:	754-216-0183
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GLENN HOLZ
Credential	:
Telephone Number	:	754-216-0183

Provider Enumeration Date	:	06/17/2020
Last Update Date	:	04/28/2021

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