Basic Information
| Provider Information | |||||||||
| NPI: | 1902328511 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROYAL PALM BEACH REHAB, CORP | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FLORIDA ORTHOCARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11211 PROSPERITY FARMS RD STE B104 | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334103453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615374526 | ||||||||
| FaxNumber: | 5616343449 | ||||||||
| Practice Location | |||||||||
| Address1: | 3355 BURNS RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334104357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615889912 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2017 | ||||||||
| LastUpdateDate: | 09/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | PAPA | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5618012535 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.