| |
16050 S Tamiami Trl Ste 109, Fort Myers, FL 33908-4243 | |
(239) 437-1155 | |
(239) 437-1451 |
Full Name | |
---|---|
Type | Facility |
Speciality | General Practice |
Location | 16050 S Tamiami Trl Ste 109, Fort Myers, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922447689 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH0003812 (Florida) | Secondary |
208D00000X | General Practice | OS5873 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
16050 S Tamiami Trl Ste 109, Fort Myers, FL 33908-4243 Ph: (239) 437-1155 | 16050 S Tamiami Trl Ste 109, Fort Myers, FL 33908-4243 Ph: (239) 437-1155 |