Island Rehabilitation Center

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

980018 Issued in FL

Legal business name

ISLAND REHABILITATION CENTER

Practice address

19 Bald Eagle Dr
Suite F
Marco Island, FL 34145-3580

Phone

(239) 394-4135

Fax

(239) 394-6921

NPI assigned

Dec 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Chulani K Fernando, PHD, MA, BSC, FAAPM,

Title

President of Island Rehabilitation

Phone

(239) 394-4135

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1013199751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BALD EAGLE DR",
            "address_2": "SUITE F",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341453580",
            "telephone_number": "239-394-4135",
            "fax_number": "239-394-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BALD EAGLE DR",
            "address_2": "SUITE F",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341453580",
            "telephone_number": "239-394-4135",
            "fax_number": "239-394-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "CHULANI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT OF ISLAND REHABILITATION",
        "authorized_official_telephone_number": "239-394-4135",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD, MA, BSC, FAAPM,"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "980018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Marco Island, FL
• Providers in Marco Island, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.