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General NPI Number Information
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NPI Number | 1891093068
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Entity Type | Organization
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Legal Business Name | BONETT REHAB CENTER INC
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 3900 BROADWAY BLDG B UNIT-7
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City | FORT MYERS
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State | FL
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Zip | 33901-8193
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Country | US
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Telephone | 239-481-2200
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Fax | 239-481-2209
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Provider Business Mailing Address
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Address Line | 3900 BROADWAY BLDG B
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City | FORT MYERS
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State | FL
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Zip | 33901-8193
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Country | US
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Telephone | 239-481-2200
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Fax | 239-481-2209
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS CARRAZANA
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Credential | D.C.
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Telephone | 239-481-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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