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6804 Porto Fino Cir Ste 1 Fort Myers FL 33912-7139 | |
| (239) 332-4700 | |
| (888) 769-5641 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 6804 Porto Fino Cir Ste 1, Fort Myers, Florida |
| Authorized Official Name and Position | Robert W Pollack (MEMBER) |
| Authorized Official Contact | 2393324700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6804 Porto Fino Cir Ste 1 Fort Myers FL 33912-7139 Ph: (239) 332-4700 | 6804 Porto Fino Cir Ste 1 Fort Myers FL 33912-7139 Ph: (239) 332-4700 |
| NPI Number | 1710395744 |
|---|---|
| Provider Enumeration Date | 07/22/2014 |
| Last Update Date | 07/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710395744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | EXEMPT (Florida) | Primary |
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