Organization
GENESIS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY CHERYL BRAVERMAN CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(239) 282-3814
Entity
Organization
Contact information
Practice address
2626 GOODLETTE RD N, NAPLES, FL 34103-4526
(239) 262-3814
(239) 262-5687
Mailing address
74 RIDGE DR, NAPLES, FL 34108-3440
(239) 254-1020
(239) 597-5289
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
SA6013
FL
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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