Organization
QUALITY PAIN REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANALYN ESCOBER DE LEON PHYSICAL THERAPIST (OWNER)
(239) 572-4779
Entity
Organization
Contact information
Practice address
501 GOODLETTE FRANK RD STE A100, NAPLES, FL 34102
(239) 572-4779
Mailing address
1065 DIANA AVE, NAPLES, FL 34103-4845
(239) 572-4779
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144536756
MEDICARE B
FL
Enumeration date
08/17/2018
Last updated
08/21/2018
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