Provider Demographics
NPI:1043404221
Name:ROYAL PHYSICAL THERAPY AND WELLNESS, CORP
Entity Type:Organization
Organization Name:ROYAL PHYSICAL THERAPY AND WELLNESS, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-226-7290
Mailing Address - Street 1:13021 NW 1ST ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2290
Mailing Address - Country:US
Mailing Address - Phone:786-226-7290
Mailing Address - Fax:
Practice Address - Street 1:809 NW 119TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2336
Practice Address - Country:US
Practice Address - Phone:786-226-7290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine