Provider Demographics
NPI:1417797390
Name:NNAS REHAB MEDICAL CENTER CORP
Entity type:Organization
Organization Name:NNAS REHAB MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SUSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-313-9988
Mailing Address - Street 1:5644 TAVILLA CIR STE 106
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-3404
Mailing Address - Country:US
Mailing Address - Phone:239-631-1995
Mailing Address - Fax:239-631-1973
Practice Address - Street 1:5644 TAVILLA CIR STE 106
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-3404
Practice Address - Country:US
Practice Address - Phone:239-631-1995
Practice Address - Fax:239-631-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy