Healthcare Provider Details

I. General information

NPI: 1073714010
Provider Name (Legal Business Name): REGIONAL REHAB ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
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

PO BOX 111090
NAPLES FL
34108-0119
US

V. Phone/Fax

Practice location:
  • Phone: 239-254-7778
  • Fax: 239-254-7718
Mailing address:
  • Phone: 239-254-7778
  • Fax: 239-254-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberOS8375
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER JOHN JAFFE
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 239-254-7778