Ft Myers Physician PA
Emergency Medicine in Cape Coral, FL. Organization (NPI-2).
NPI number1437209855
StatusActive
Last updated in NPPESApr 20, 2008
Details
- NPI
- 1437209855
- Entity type
- Organization (NPI-2)
- Legal business name
- Ft Myers Physician PA
- Organization subpart
- No
- Enumeration date
- Jan 10, 2007
- Last updated
- Apr 20, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | ME36712 | FL | Yes |
Practice location
2721 Del Prado Blvd SSuite 240
Cape Coral, FL 33904-5781
Phone 239-333-0084 · Fax 239-333-0086
Mailing address
2721 Del Prado Blvd SSuite 240
Cape Coral, FL 33904-5781
Phone 239-333-0084 · Fax 239-333-0086
Authorized official
Dana Gerald Killam
President
2393330084
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