Provider Demographics
NPI:1083099477
Name:ROYAL PALM BEACH REHAB, CORP
Entity Type:Organization
Organization Name:ROYAL PALM BEACH REHAB, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-801-2535
Mailing Address - Street 1:4971 LE CHALET BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1418
Mailing Address - Country:US
Mailing Address - Phone:561-733-5590
Mailing Address - Fax:561-740-0714
Practice Address - Street 1:170 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6714
Practice Address - Country:US
Practice Address - Phone:786-272-5697
Practice Address - Fax:786-364-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty