Provider Demographics
NPI:1528000981
Name:SBM REHABILITATION MEDICAL CENTER
Entity Type:Organization
Organization Name:SBM REHABILITATION MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-296-1116
Mailing Address - Street 1:6300 S DIXIE HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-4348
Mailing Address - Country:US
Mailing Address - Phone:561-261-1116
Mailing Address - Fax:561-261-1118
Practice Address - Street 1:6300 S DIXIE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-4348
Practice Address - Country:US
Practice Address - Phone:561-261-1116
Practice Address - Fax:561-261-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78736AMedicare PIN
FLK5697Medicare PIN