Ge Spine Orthopedic Sports Therapy Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT0007217 Issued in FL

Legal business name

GE SPINE ORTHOPEDIC SPORTS THERAPY CENTER LLC

Practice address

7331 College Pkwy Ste 230
Fort Myers, FL 33907-5524

Phone

(941) 268-5577

NPI assigned

Feb 4, 2013

Last updated

Feb 4, 2013By 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

Edgar Comson Penano, RPTNPI 1124466685

Title

President

Phone

(941) 268-5577

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Edgar Comson Penano, P.T.

  • Physical Therapist
  • Fort Myers, FL
  • NPI 1124466685
  Medicare reassignment Care Compare group NPD Authorized official
• Slavica Krushenka Bjazevic

  • Occupational Therapist
  • Fort Myers, FL
  • NPI 1578206025
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1598004053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7331 COLLEGE PKWY STE 230",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075524",
            "telephone_number": "941-268-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7331 COLLEGE PKWY STE 230",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075524",
            "telephone_number": "941-268-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GE SPINE ORTHOPEDIC SPORTS THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "PENANO",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "COMSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-268-5577",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT0007217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL PT",
            "identifier": "PT0007217",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia A Gavilanes
• David Nicholas Gavin, DPM
• Janette U. Gaw, MD
• Juan Gaztanaga, M.D.
• Deborah Oluwamayowa Gbadamosi, LMHC
• Gear & Yavorsky D.D.S. P.a.
• Gear, Oakes-Lottridge, Scheel and Hamm Dentistry Partnership (Caloosa Dental)
• Robert Dale Gear Jr., DMD, MD
• Robert Dale Gear Sr., D.D.S.
• Sarah Michelle Geary

• Physical Therapy Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.