Healthcare Provider Details

I. General information

NPI: 1497616619
Provider Name (Legal Business Name): EAST NAPLES REHABILITATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 TAMIAMI TRL E STE 1
NAPLES FL
34112-6251
US

IV. Provider business mailing address

3906 TAMIAMI TRL E STE 1
NAPLES FL
34112-6251
US

V. Phone/Fax

Practice location:
  • Phone: 239-530-0201
  • Fax: 239-300-9631
Mailing address:
  • Phone: 239-530-0201
  • Fax: 239-300-9631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: EMILY JANE PARKS
Title or Position: PRESIDENT
Credential: DPT
Phone: 248-820-9457