MEDICARE: 1M&M PHYSICAL THERAPY AND FITNESS SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1215865373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1M&M PHYSICAL THERAPY AND FITNESS SERVICES LLC

Provider Business Mailing Address
First Line	:	8975 KAYAK DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-4200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8975 KAYAK DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-4200
Country	:	US
Telephone Number	:	765-212-0265
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RAJU NEELAKANDAN
Credential	:
Telephone Number	:	765-212-0265

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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