Provider Demographics
NPI:1982179883
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:CEO
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 1:11211 PROSPERITY FARMS RD STE B104
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3453
Mailing Address - Country:US
Mailing Address - Phone:561-537-4526
Mailing Address - Fax:561-634-3449
Practice Address - Street 1:6150 METROWEST BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3290
Practice Address - Country:US
Practice Address - Phone:561-588-9912
Practice Address - Fax:561-828-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-06
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002075000Medicaid