Provider Demographics
NPI:1376104307
Name:PELVIC REHABILITATION MEDICINE, PC
Entity Type:Organization
Organization Name:PELVIC REHABILITATION MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIMINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-805-3873
Mailing Address - Street 1:2090 PALM BEACH LAKES BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6508
Mailing Address - Country:US
Mailing Address - Phone:207-752-0388
Mailing Address - Fax:
Practice Address - Street 1:106 GRAND AVE STE 435
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3574
Practice Address - Country:US
Practice Address - Phone:201-266-3553
Practice Address - Fax:201-266-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty