Provider Demographics
NPI:1316651276
Name:PALM BEACH PHYSICAL MEDICINE AND REHABILITATION,LLC
Entity type:Organization
Organization Name:PALM BEACH PHYSICAL MEDICINE AND REHABILITATION,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-408-3836
Mailing Address - Street 1:443 NW PRIMA VISTA BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-8731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:443 NW PRIMA VISTA BLVD STE 106
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-8731
Practice Address - Country:US
Practice Address - Phone:561-530-4655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALM BEACH PHYSICAL MEDICINE AND REHABILITATION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty