Provider Demographics
NPI:1518436989
Name:NEW LIFE REHAB MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:NEW LIFE REHAB MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:YISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEQUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-302-5081
Mailing Address - Street 1:689 9TH ST N STE E
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-8100
Mailing Address - Country:US
Mailing Address - Phone:239-302-5081
Mailing Address - Fax:239-330-7068
Practice Address - Street 1:689 9TH ST N STE E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-8100
Practice Address - Country:US
Practice Address - Phone:239-302-5081
Practice Address - Fax:239-330-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty