Basic Information
| Provider Information | |||||||||
| NPI: | 1720150261 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROWARD REHABILITATION MEDICINE ASSOCIATES PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 740463 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617395136 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3487 N W 30 AVENUE | ||||||||
| Address2: | |||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547396233 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2006 | ||||||||
| LastUpdateDate: | 07/03/2013 | ||||||||
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| AuthorizedOfficialLastName: | CARNEY | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | CHARLES | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5617347598 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | SR. | ||||||||
| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.