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NPI Code Detail

MEDICARE: FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.

MEDICARE: FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1174536502
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.
Provider Business Mailing Address
First Line : 255 WASHINGTON ST STE 230
Second Line :
City : NEWTON
State : MA
Zip : 02458-1644
Country : US
Telephone Number : 617-796-8387
Fax Number :
Provider Business Practice Location Address
First Line : 2674 WINKLER AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9361
Country : US
Telephone Number : 239-466-9222
Fax Number : 239-454-9333
Authorized Official
Title or Position : PRESIDENT & CHIEF EXECUTIVE OFFICER
Name : JEFFREY C LEER
Credential :
Telephone Number : 617-796-8387
Provider Enumeration Date : 08/15/2006
Last Update Date : 10/20/2022

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