Provider Demographics
NPI:1720310352
Name:ROYAL PALM BEACH REHAB, CORP
Entity Type:Organization
Organization Name:ROYAL PALM BEACH REHAB, CORP
Other - Org Name:ACTION PHYSICAL
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:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-801-2535
Mailing Address - Street 1:4971 LE CHALET BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1418
Mailing Address - Country:US
Mailing Address - Phone:561-733-5590
Mailing Address - Fax:561-740-0714
Practice Address - Street 1:4971 LE CHALET BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1418
Practice Address - Country:US
Practice Address - Phone:561-733-5590
Practice Address - Fax:561-740-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002075004Medicaid
FL002075004Medicaid