SWFL Scientific Rejuvenation LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SWFL SCIENTIFIC REJUVENATION LLC

Practice address

122 Nesbit St
Punta Gorda, FL 33950-3653

Phone

(239) 270-2882

NPI assigned

Sep 3, 2021

Last updated

Sep 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rae Ann Antonucci, PA

Title

Owner

Phone

(941) 662-6750

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rae Ann Antonucci, P.A.

  • Medical Physician Assistant
  • Punta Gorda, FL
  • NPI 1619155009
  NPD
• Melissa Facey

  • Family Nurse Practitioner
  • Fort Myers, FL
  • NPI 1023478278
  NPD

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1023786928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 NESBIT ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503653",
            "telephone_number": "239-270-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NESBIT ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503653",
            "telephone_number": "239-270-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWFL SCIENTIFIC REJUVENATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "ANTONUCCI",
        "authorized_official_first_name": "RAE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-662-6750",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley Whiton Sunter, PHARMD
• Ginou Supre
• Kathleen Sutherland, RPH, BS
• Sutter J. Caton, P.T., LLC (Babcock Movement Physiotherapy & Wellness)
• SW Florida Cardiovascular Institute PLLC
• Sarah R. Swiatek, PHARM.D.
• Synergic Healthcare Solutions LLC
• Synergy Hospital Services LLC
• T.H.E. Therapy Works
• Gary N Talbott, LCSW

• Medical Specialty Clinic/Center in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.