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General NPI Number Information
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NPI Number | 1821658428
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE REHAB MEDICINE, INC
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 9351 CORKSCREW RD STE 103
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City | ESTERO
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State | FL
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Zip | 33928-6801
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Country | US
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Telephone | 239-687-3199
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Fax |
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Provider Business Mailing Address
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Address Line | 9351 CORKSCREW RD STE 103
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City | ESTERO
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State | FL
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Zip | 33928-6801
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Country | US
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Telephone | 239-687-3199
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SEBASTIAN KLISIEWICZ
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Credential | DO
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Telephone | 773-895-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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