1255741187 NPI number — ROYAL PALM BEACH REHAB, CORP

Table of content: (NPI 1255741187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255741187 NPI number — ROYAL PALM BEACH REHAB, CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYAL PALM BEACH REHAB, CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACTION PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255741187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4971 LE CHALET BLVD
Provider Second Line Business Mailing Address:
100
Provider Business Mailing Address City Name:
BOYNTON BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33436-1418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-733-5590
Provider Business Mailing Address Fax Number:
561-740-0714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5149 S UNIVERSITY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33328-4507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-900-8857
Provider Business Practice Location Address Fax Number:
954-212-6364
Provider Enumeration Date:
04/30/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PAPA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
561-801-2535

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)