Provider Demographics
NPI:1023266046
Name:PROFESSIONAL REHAB AND WELLNESS INC
Entity type:Organization
Organization Name:PROFESSIONAL REHAB AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:561-204-1694
Mailing Address - Street 1:1128 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:#243
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1693
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:561-204-1694
Practice Address - Street 1:1128 ROYAL PALM BEACH BLVD
Practice Address - Street 2:#243
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1693
Practice Address - Country:US
Practice Address - Phone:561-204-1694
Practice Address - Fax:561-204-1694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19335261QP2000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy