Healthcare Provider Details

I. General information

NPI: 1831994615
Provider Name (Legal Business Name): REGIONAL REHAB ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 DEL PRADO BLVD S
CAPE CORAL FL
33990-2629
US

IV. Provider business mailing address

455 DEL PRADO BLVD S
CAPE CORAL FL
33990-2629
US

V. Phone/Fax

Practice location:
  • Phone: 239-319-4545
  • Fax:
Mailing address:
  • Phone: 239-254-7778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PETER JOHN JAFFE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 239-254-7778