Organization
THE ISLANDS THERAPEUTIC AND REHABILITATIVE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN FRANKLIN CHACO LMT (OWNER)
(813) 962-4158
Entity
Organization
Contact information
Practice address
3820 GUNN HWY UNIT AB, TAMPA, FL 33618-8720
(813) 962-4158
(813) 962-4768
Mailing address
3820 GUNN HWY UNIT AB, TAMPA, FL 33618-8720
(813) 962-4158
(813) 962-4768
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MA46993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427228048
NPI
FL
Enumeration date
04/07/2010
Last updated
04/07/2010
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