NPIMap

Organization Active NPI

Rehab Source P a

Doing business as Collier Physical Therapy

  • Physical Therapist
  • Naples, FL
National Provider Identifier
1477574655
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0007692 Issued in FL
Legal business name
REHAB SOURCE P A
Doing business as
Collier Physical Therapy
Practice address
6825 Davis Blvd
#157
Naples, FL 34104-5331
Phone
(239) 643-7879
Fax
(239) 643-2951
NPI assigned
Jul 22, 2006
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Mr. Edsel PagkanlunganNPI 1023202629
Title
President
Phone
(239) 643-7879

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT0007692 FL Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT0008895 FL

Addresses

Primary practice location

6825 Davis Blvd
#157
Naples, FL 34104-5331

Mailing address

6825 Davis Blvd Apt 257
Naples, FL 34104-5326
Phone (239) 643-7879

Other names 1

  • Collier Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

3940 Radio Rd
Ste 109
Naples, FL 34104
Phone (239) 530-2796

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1477574655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6825 DAVIS BLVD APT 257",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341045326",
            "telephone_number": "239-643-7879",
            "fax_number": "239-643-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 DAVIS BLVD",
            "address_2": "#157",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341045331",
            "telephone_number": "239-643-7879",
            "fax_number": "239-643-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB SOURCE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "PAGKANLUNGAN",
        "authorized_official_first_name": "EDSEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-643-7879",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT0007692",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT0008895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collier Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Collier Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.