Provider Demographics
NPI:1700930773
Name:HEALTH AND REHAB CENTER OF THE PALM BEACHES INC
Entity Type:Organization
Organization Name:HEALTH AND REHAB CENTER OF THE PALM BEACHES INC
Other - Org Name:HEALTH AND REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-630-8722
Mailing Address - Street 1:11951 U.S. HWY 1
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2804
Mailing Address - Country:US
Mailing Address - Phone:561-630-8722
Mailing Address - Fax:561-630-8729
Practice Address - Street 1:11951 U.S. HWY 1
Practice Address - Street 2:SUITE 105
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-630-8722
Practice Address - Fax:561-630-8729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
FL15947225100000X
FL19114225100000X
FLPT19114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889096000Medicaid
FL889096000Medicaid
FL889096000Medicaid
FLY910RMedicare PIN