MEDICARE: SOLARIS REHAB, 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
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1689348062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLARIS REHAB, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2386
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34133-2386
Country	:	US
Telephone Number	:	239-488-1583
Fax Number	:

Provider Business Practice Location Address
First Line	:	1906 SKYLINE BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-3388
Country	:	US
Telephone Number	:	239-488-1583
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATTI CARLSON
Credential	:
Telephone Number	:	239-206-8187

Provider Enumeration Date	:	08/09/2021
Last Update Date	:	02/19/2026

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