Provider Demographics
NPI:1740585199
Name:ADVANCED OCEAN REHAB INC
Entity Type:Organization
Organization Name:ADVANCED OCEAN REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SATERTHWAITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-369-4276
Mailing Address - Street 1:11381 PROSPERITY FARMS RD
Mailing Address - Street 2:320
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11381 PROSPERITY FARMS RD
Practice Address - Street 2:320
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3403
Practice Address - Country:US
Practice Address - Phone:561-369-4276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy