Provider Demographics
NPI:1447384219
Name:SUNSHINE REHABILITATION INC
Entity Type:Organization
Organization Name:SUNSHINE REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PERIASWAMY
Authorized Official - Middle Name:SUBASH
Authorized Official - Last Name:CHANDAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:239-437-6620
Mailing Address - Street 1:6710 WINKLER RD
Mailing Address - Street 2:UNIT # 4
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-7274
Mailing Address - Country:US
Mailing Address - Phone:239-437-6620
Mailing Address - Fax:239-437-6619
Practice Address - Street 1:6710 WINKLER RD
Practice Address - Street 2:UNIT # 4
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7274
Practice Address - Country:US
Practice Address - Phone:239-437-6620
Practice Address - Fax:239-437-6619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY904JOtherBCBS
FLY904JOtherBCBS