Healthcare Provider Details

I. General information

NPI: 1770782815
Provider Name (Legal Business Name): PHYSICAL THERAPY CLINIC OF NAPLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 VETERANS PARK DR SUITE 101
NAPLES FL
34109-0447
US

IV. Provider business mailing address

1865 VETERANS PARK DR SUITE 101
NAPLES FL
34109-0447
US

V. Phone/Fax

Practice location:
  • Phone: 239-597-0787
  • Fax: 239-325-1057
Mailing address:
  • Phone: 239-597-0787
  • Fax: 239-325-1057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT21327
License Number StateFL

VIII. Authorized Official

Name: MS. KATHLEEN BELTON HOEFT
Title or Position: DIRECTOR OF FITNESS
Credential: MPT, ATC
Phone: 239-597-0787