East Lee County Rebabilitation Center Inc

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

PT0004617 Issued in FL

Legal business name

EAST LEE COUNTY REBABILITATION CENTER INC

Practice address

1150 Lee Blvd
Suite C
Lehigh Acres, FL 33936-4805

Phone

(239) 369-0577

Fax

(239) 369-7540

NPI assigned

Nov 21, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Carlo T Penaranda, REGISTERED PT

Title

Administrator & Physical Therapist

Phone

(239) 369-0577

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942283379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 LEE BLVD",
            "address_2": "SUITE C",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364805",
            "telephone_number": "239-369-0577",
            "fax_number": "239-369-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 LEE BLVD",
            "address_2": "SUITE C",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339364805",
            "telephone_number": "239-369-0577",
            "fax_number": "239-369-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LEE COUNTY REBABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENARANDA",
        "authorized_official_first_name": "CARLO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR & PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "239-369-0577",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REGISTERED PT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "FL",
            "license": "PT0004617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Q33",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.