MEDICARE: NAPLES REHAB, INC

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	103K00000X	Behavior Analyst	MH5946	FL

General Provider Information

NPI Number	:	1265869762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPLES REHAB, INC

Provider Business Mailing Address
First Line	:	4100 CORPORATE SQ
Second Line	:	UNIT 154
City	:	NAPLES
State	:	FL
Zip	:	34104-4714
Country	:	US
Telephone Number	:	239-400-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 CORPORATE SQ
Second Line	:	UNIT 154
City	:	NAPLES
State	:	FL
Zip	:	34104-4714
Country	:	US
Telephone Number	:	239-400-5555
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DENNIS WILKINSON
Credential	:	MH COUNSELER
Telephone Number	:	239-400-5555

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	09/30/2013

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Directions to “NAPLES REHAB, INC ” Practice Location

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