Provider Demographics
NPI:1538941877
Name:LIFE FOREVER MEDICAL & REHAB CENTER INC
Entity type:Organization
Organization Name:LIFE FOREVER MEDICAL & REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMLET
Authorized Official - Middle Name:
Authorized Official - Last Name:PERIU
Authorized Official - Suffix:
Authorized Official - Credentials:P
Authorized Official - Phone:239-776-7987
Mailing Address - Street 1:2977 GOODLETTE-FRANK RD N STE 40
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4615
Mailing Address - Country:US
Mailing Address - Phone:239-776-7987
Mailing Address - Fax:239-776-7989
Practice Address - Street 1:2977 GOODLETTE-FRANK RD N STE 40
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4615
Practice Address - Country:US
Practice Address - Phone:239-776-7987
Practice Address - Fax:239-776-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center