Provider Demographics
NPI:1154085082
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:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MASELLI
Authorized Official - Last Name:GUADAGNINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-537-4526
Mailing Address - Street 1:4971 LE CHALET BLVD STE 100
Mailing Address - Street 2:
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:
Practice Address - Street 1:3003 CLAIRE LANE
Practice Address - Street 2:BUILDING 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:904-593-5470
Practice Address - Fax:904-593-5472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty