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535 Pine Island Rd Suite 109 Fort Myers FL 33903-3700 | |
| (239) 656-7700 | |
| (239) 656-7702 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 535 Pine Island Rd, Fort Myers, Florida |
| Authorized Official Name and Position | Nancy Hamilton (CEO) |
| Authorized Official Contact | 7275457564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
535 Pine Island Rd Suite 109 Fort Myers FL 33903-3700 Ph: (239) 656-7700 | 535 Pine Island Rd Suite 109 Fort Myers FL 33903-3700 Ph: (239) 656-7700 |
| NPI Number | 1184782633 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184782633 | NPI | - | NPPES |
| 070878000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Florida) | Primary |
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