Healthcare Provider Details

I. General information

NPI: 1275803348
Provider Name (Legal Business Name): NAPLES INJURY AND REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 GOLDEN GATE PKWY STE 5
NAPLES FL
34116-7524
US

IV. Provider business mailing address

5080 ANNUNCIATION CIR UNIT 104
AVE MARIA FL
34142-9655
US

V. Phone/Fax

Practice location:
  • Phone: 239-234-6152
  • Fax:
Mailing address:
  • Phone: 239-348-1696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT ALLAN
Title or Position: DIRECTOR
Credential:
Phone: 239-348-1696