Basic Information
| Provider Information | |||||||||
| NPI: | 1598496986 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROYAL PALM BEACH REHAB CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4971 LE CHALET BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334361418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615702501 | ||||||||
| FaxNumber: | 5618282908 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 N US HIGHWAY 1 UNIT 606A | ||||||||
| Address2: | |||||||||
| City: | FORT PIERCE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349503072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615702501 | ||||||||
| FaxNumber: | 5618282908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2022 | ||||||||
| LastUpdateDate: | 06/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | GARCIA | ||||||||
| AuthorizedOfficialFirstName: | JORGE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5615374526 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.