Provider Demographics
NPI:1588998314
Name:ISLAND THERAPY SERVICES OF SANIBEL, LLC
Entity type:Organization
Organization Name:ISLAND THERAPY SERVICES OF SANIBEL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:SALVAGE
Authorized Official - Last Name:TRITAIK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:239-297-4997
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-0867
Mailing Address - Country:US
Mailing Address - Phone:239-395-5858
Mailing Address - Fax:239-395-5858
Practice Address - Street 1:695 TARPON BAY RD UNIT 1
Practice Address - Street 2:
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-3135
Practice Address - Country:US
Practice Address - Phone:239-395-5858
Practice Address - Fax:239-395-5857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-26
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation