The Islands Therapeutic and Rehabilitative Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MA46993 Issued in FL

Legal business name

THE ISLANDS THERAPEUTIC AND REHABILITATIVE CENTER, LLC

Practice address

3820 Gunn Hwy Unit Ab
Tampa, FL 33618-8720

Phone

(813) 962-4158

Fax

(813) 962-4768

NPI assigned

Apr 7, 2010

Organization subpart

No

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

Authorized official

Name

Shawn Franklin Chaco, LMT

Title

Owner

Phone

(813) 962-4158

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1053637686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 GUNN HWY UNIT AB",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336188720",
            "telephone_number": "813-962-4158",
            "fax_number": "813-962-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 GUNN HWY UNIT AB",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336188720",
            "telephone_number": "813-962-4158",
            "fax_number": "813-962-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ISLANDS THERAPEUTIC AND REHABILITATIVE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "CHACO",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-962-4158",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "MA46993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427228048",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.