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General NPI Number Information
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NPI Number | 1386140754
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Entity Type | Organization
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Legal Business Name | IPPOLITO REHABILITATION, LLC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 3569 PILOT CIR
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City | NAPLES
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State | FL
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Zip | 34120-0714
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Country | US
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Telephone | 239-390-3978
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Fax |
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Provider Business Mailing Address
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Address Line | 3569 PILOT CIR
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City | NAPLES
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State | FL
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Zip | 34120-0714
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Country | US
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Telephone | 239-390-3978
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. CHRISTOPHER PHILLIP IPPOLITO
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Credential | PT, DPT
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Telephone | 239-293-5042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | FL
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