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Organization
EAST LEE COUNTY REBABILITATION CENTER INC
Active
Organization
EAST LEE COUNTY REBABILITATION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLO T PENARANDA REGISTERED PT (ADMINISTRATOR & PHYSICAL THERAPIST)
(239) 369-0577
Entity
Organization
Contact information
Practice address
1150 LEE BLVD, SUITE C, LEHIGH ACRES, FL 33936-4805
(239) 369-0577
(239) 369-7540
Mailing address
1150 LEE BLVD, SUITE C, LEHIGH ACRES, FL 33936-4805
(239) 369-0577
(239) 369-7540
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
PT0004617
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q33
BCBS
FL
Enumeration date
11/21/2005
Last updated
08/22/2020
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