Healthcare Provider Details

I. General information

NPI: 1699458026
Provider Name (Legal Business Name): PHYSICAL THERAPY CENTER OF NAPLES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4186 TAMIAMI TRL N
NAPLES FL
34103-3124
US

IV. Provider business mailing address

PO BOX 1891
IMMOKALEE FL
34143-1891
US

V. Phone/Fax

Practice location:
  • Phone: 239-234-6145
  • Fax: 239-610-2825
Mailing address:
  • Phone: 239-234-6145
  • Fax: 239-610-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIMITRI SCHWARZ
Title or Position: OPERATIONAL MANAGER
Credential:
Phone: 239-234-6145