| NPI | 1710482948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN DANIEL DORNEVIL Physical Therapist/Owner 239-672-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QR0400X Clinic/Center Rehabilitation (Licence: FL PT30933) | |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0800X Clinic/Center Recovery Care | |
| 261QH0100X Clinic/Center Health Service | |
| 261QP3300X Clinic/Center Pain | |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-08-19 |