Healthcare Provider Details

I. General information

NPI: 1063217826
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: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 TAMIAMI TRL N STE 1
NAPLES FL
34102-6215
US

IV. Provider business mailing address

150 TAMIAMI TRL N STE 1
NAPLES FL
34102-6215
US

V. Phone/Fax

Practice location:
  • Phone: 239-331-8551
  • Fax:
Mailing address:
  • Phone: 239-254-7778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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