Bonita Community Health Center Inc

Organization Active NPI Physical Medicine & Rehabilitation Physician · Estero, FL

NPI 1760459762 · NPPES record last updated Apr 3, 2019

Key facts

NPI
1760459762
Entity type
Organization (NPI type 2)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
PT 21826 (FL)
Legal business name
BONITA COMMUNITY HEALTH CENTER INC
Practice address
3501 Health Center Blvd
Estero, FL 34135-8127
Phone
(239) 949-1050
NPI assigned
Mar 8, 2006
Organization subpart
No

Authorized official

Name
Mr. Michael Riley
Title
Ceo
Phone
(239) 949-1050

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208100000X PT 21826 FL Yes

Addresses

Primary practice location

3501 Health Center Blvd
Estero, FL 34135-8127

Mailing address

3501 Health Center Blvd
Bonita Springs, FL 34135-8127
Phone (239) 949-1050

Other identifiers

IdentifierTypeStateIssuer
45737OtherFLBCBS FLORIDA

Other names

  • BONITA COMMUNITY REHAB CENTER Doing business as

Other providers in Estero, FL

All providers in Estero, FL · Physical Medicine & Rehabilitation Physician in Florida

Sources for this page

Verify at the official NPI Registry.