Provider Demographics
NPI:1114287653
Name:INJURY TREATMENT CENTER OF NAPLES, LLC
Entity Type:Organization
Organization Name:INJURY TREATMENT CENTER OF NAPLES, LLC
Other - Org Name:CHOICE MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-445-4613
Mailing Address - Street 1:2295 NW CORPORATE BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7373
Mailing Address - Country:US
Mailing Address - Phone:561-988-1022
Mailing Address - Fax:561-988-0426
Practice Address - Street 1:2171 PINE RIDGE RD
Practice Address - Street 2:SUITE E
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2002
Practice Address - Country:US
Practice Address - Phone:239-325-2909
Practice Address - Fax:239-325-2914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty