| |
12681 New Brittany Blvd # 1e, Fort Myers, FL 33907-3631 | |
(239) 689-3843 | |
(239) 689-3852 |
Full Name | |
---|---|
Type | Facility |
Speciality | Non-pharmacy Dispensing Site |
Location | 12681 New Brittany Blvd # 1e, Fort Myers, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679177661 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213EP1101X | Podiatrist - Primary Podiatric Medicine | (* (Not Available)) | Secondary |
332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
12681 New Brittany Blvd # 1e, Fort Myers, FL 33907-3631 Ph: (239) 689-3843 | 12681 New Brittany Blvd # 1e, Fort Myers, FL 33907-3631 Ph: (239) 689-3843 |