Organization
PRIME MEDICAL REHAB CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CYRIL PHILIP CHORATH (ADMINISTRATOR)
(954) 535-7676
Entity
Organization
Contact information
Practice address
2331 N STATE ROAD 7, SUITE 118, LAUDERDALE LAKES, FL 33313-3748
(954) 535-7676
(954) 535-2909
Mailing address
2331 N STATE ROAD 7, SUITE 118, LAUDERDALE LAKES, FL 33313-3748
(954) 535-7676
(954) 535-2909
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
ME34371
FL
225100000X
Physical Therapist
PT 17717
FL
225200000X
Physical Therapy Assistant
PTA16340
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC4364
CLINIC LICENSE
FL
Enumeration date
12/13/2006
Last updated
09/11/2025
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