MEDICARE: NAPLES INJURY AND 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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1275803348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPLES INJURY AND REHAB INC.

Provider Business Mailing Address
First Line	:	5080 ANNUNCIATION CIR UNIT 104
Second Line	:
City	:	AVE MARIA
State	:	FL
Zip	:	34142-9655
Country	:	US
Telephone Number	:	239-348-1696
Fax Number	:

Provider Business Practice Location Address
First Line	:	5425 GOLDEN GATE PKWY STE 5
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34116-7524
Country	:	US
Telephone Number	:	239-234-6152
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SCOTT ALLAN
Credential	:
Telephone Number	:	239-348-1696

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	01/06/2012

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